Basic Information
| Provider Information | |||||||||
| NPI: | 1336529247 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHOLAR | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 POLE CREEK XING | ||||||||
| Address2: | |||||||||
| City: | SIDNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 691622901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3082545825 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 POLE CREEK XING | ||||||||
| Address2: | |||||||||
| City: | SIDNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 69162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3082545825 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2015 | ||||||||
| LastUpdateDate: | 06/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | UO 4615 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS14547 | FL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 1998 | NE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.