Basic Information
| Provider Information | |||||||||
| NPI: | 1760511646 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAUCIER | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | ANTHONY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 511 PALADIN DR | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278347826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527528880 | ||||||||
| FaxNumber: | 2523173092 | ||||||||
| Practice Location | |||||||||
| Address1: | 970 NEWMAN RD | ||||||||
| Address2: | |||||||||
| City: | NEW BERN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285625200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2526339262 | ||||||||
| FaxNumber: | 2523172094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 12/27/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 50134 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 2005-01698 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 281622000 | 05 | MN | MEDICAID | P00468510 | 01 | MN | RAILROAD MEDICARE | OTHER |