Provider Demographics
NPI:1215012851
Name:ALDERMAN, SARA M (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:ALDERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1897 OHIO DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-4839
Mailing Address - Country:US
Mailing Address - Phone:614-875-1721
Mailing Address - Fax:614-820-2337
Practice Address - Street 1:1897 OHIO DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-4839
Practice Address - Country:US
Practice Address - Phone:614-875-1721
Practice Address - Fax:614-820-2337
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-088486207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2731986Medicaid
OHAL4208651OtherMEDICARE PTAN
OH262648439OtherCOMMERICAL
OH262648439027OtherCARESOURCE
000000591600OtherANTHEM
OHI68382Medicare UPIN