Basic Information
Provider Information
NPI: 1528048790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELL
FirstName: SARA
MiddleName: NATH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 116 WOODLANDS W
Address2:  
City: COLUMBIA
State: SC
PostalCode: 292293377
CountryCode: US
TelephoneNumber: 8034191397
FaxNumber:  
Practice Location
Address1: 3000 NE MEDICAL PARK
Address2: SUITE 209
City: COLUMBIA
State: SC
PostalCode: 292236251
CountryCode: US
TelephoneNumber: 8037366262
FaxNumber: 8036991934
Other Information
ProviderEnumerationDate: 01/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X19973SCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home