Provider Demographics
NPI:1417343542
Name:SEWELL, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:500 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2610
Mailing Address - Country:US
Mailing Address - Phone:614-455-8150
Mailing Address - Fax:419-455-8159
Practice Address - Street 1:500 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2610
Practice Address - Country:US
Practice Address - Phone:419-455-8150
Practice Address - Fax:419-455-8159
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34013167208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0305589Medicaid