Provider Demographics
NPI:1528128121
Name:ELEANOR E. SAHN MD PC
Entity type:Organization
Organization Name:ELEANOR E. SAHN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-971-4460
Mailing Address - Street 1:225 SEVEN FARMS DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8353
Mailing Address - Country:US
Mailing Address - Phone:843-971-4460
Mailing Address - Fax:843-971-0991
Practice Address - Street 1:225 SEVEN FARMS DR
Practice Address - Street 2:SUITE 105
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8353
Practice Address - Country:US
Practice Address - Phone:843-971-4460
Practice Address - Fax:843-971-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11665207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC070016710OtherRR MEDICARE
SCGP3471Medicaid
SCGP3471Medicaid
SC070016710OtherRR MEDICARE
SCB926637334Medicare PIN