Provider Demographics
NPI:1144528001
Name:WOLDEMICHAEL, SARA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:WOLDEMICHAEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 BETHUNE DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4155
Mailing Address - Country:US
Mailing Address - Phone:443-742-1303
Mailing Address - Fax:
Practice Address - Street 1:101 MARLBORO AVE STE 15
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2740
Practice Address - Country:US
Practice Address - Phone:410-822-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16418183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist