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Individual

MRS. SARA H BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4630 HIGHWAY 17, MURRELLS INLET, SC 29576-5016
(843) 357-2299
(843) 357-2720
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
776
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578PA
SC
Enumeration date
08/24/2006
Last updated
01/16/2014
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