Provider Demographics
NPI:1114260775
Name:SAUM, JAMES LEROY
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEROY
Last Name:SAUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S THOMAN ST
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:OH
Mailing Address - Zip Code:44827-1850
Mailing Address - Country:US
Mailing Address - Phone:419-834-5481
Mailing Address - Fax:
Practice Address - Street 1:504 S THOMAN ST
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:OH
Practice Address - Zip Code:44827-1850
Practice Address - Country:US
Practice Address - Phone:419-834-5481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide