Basic Information
Provider Information
NPI: 1619196847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KLEIN
FirstName: SARAH
MiddleName: MCMILLAN
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 340 EISENHOWER DR
Address2: BLDG. 1500
City: SAVANNAH
State: GA
PostalCode: 314061600
CountryCode: US
TelephoneNumber: 9123546614
FaxNumber: 9123569078
Practice Location
Address1: 340 EISENHOWER DR
Address2: BLDG. 1500
City: SAVANNAH
State: GA
PostalCode: 314061600
CountryCode: US
TelephoneNumber: 9123546614
FaxNumber: 9123569078
Other Information
ProviderEnumerationDate: 04/25/2007
LastUpdateDate: 02/26/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X004355GAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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