Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 30024572 | OH |
N | 1223D0004X | Dentist Anesthesiologist | RES.3304 | OH |
NPI | 1598010522 |
---|---|
Provider Name | Sarah Marks Leach |
First Address | North Charleston, SC 29418-5902 |
Second Address | North Charleston, SC 29418-5902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | OH |