Provider Demographics
NPI:1043371156
Name:HEDRICK, SARAH M (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:M
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:M
Other - Last Name:WEGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:33 W RAHN RD
Mailing Address - Street 2:# 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2219
Mailing Address - Country:US
Mailing Address - Phone:937-433-8990
Mailing Address - Fax:
Practice Address - Street 1:6661 CLYO RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2702
Practice Address - Country:US
Practice Address - Phone:937-425-4000
Practice Address - Fax:937-425-4002
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090477207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3120116Medicaid
OH3120116Medicaid