Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | MD61030955 | WA |
NPI | 1356736730 |
---|---|
Provider Name | Sarah Mazher Kidwai |
First Address | New Hyde Park, NY 11040-2305 |
Second Address | Seattle, WA 98195-2305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 13/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1356736730 | (05) | WA |