Basic Information
Provider Information
NPI: 1053721126
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LESTER
FirstName: SARA
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3104 BLUE LAKE DR STE 110
Address2:  
City: VESTAVIA
State: AL
PostalCode: 352432372
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3690 GRANDVIEW PKWY
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352433326
CountryCode: US
TelephoneNumber: 2059771949
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/29/2014
LastUpdateDate: 05/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000X34476ALY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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