Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 17438 | NC |
N | 2080P0216X | Pediatric Rheumatologist | 17438 | NC |
NPI | 1326022401 |
---|---|
Provider Name | Sara Hendricks Sinal |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 21/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2007343000 | (05) | WV |
2676 | PARTNERS (01) | |
30797 | MEDCOST (01) | |
5872089 | AETNA (01) | |
6722075 | (05) | VA |
76460 | BCBS (01) | |
8976460 | (05) | NC |
C89494 | (02) | |
Q17439 | (05) | SC |