Provider Demographics
NPI:1164622247
Name:SAWHNEY, VISHAL (MD)
Entity Type:Individual
Prefix:
First Name:VISHAL
Middle Name:
Last Name:SAWHNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 HARRISON AVE NW STE 101
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2628
Mailing Address - Country:US
Mailing Address - Phone:234-214-0671
Mailing Address - Fax:330-956-5270
Practice Address - Street 1:1445 HARRISON AVE NW
Practice Address - Street 2:SUITE 101
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2620
Practice Address - Country:US
Practice Address - Phone:234-214-0671
Practice Address - Fax:330-956-5270
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2287207RC0200X, 207RP1001X, 207RS0012X
OH35-090112207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062597Medicaid
OH0062597Medicaid
OHH104500Medicare PIN