Provider Demographics
NPI:1467519108
Name:ASAZAWA, SANDI LEE (PA)
Entity Type:Individual
Prefix:MRS
First Name:SANDI
Middle Name:LEE
Last Name:ASAZAWA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:36524 SPINDRIFT DR
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-1348
Mailing Address - Country:US
Mailing Address - Phone:440-239-3438
Mailing Address - Fax:440-239-3438
Practice Address - Street 1:7271 ENGLE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8488
Practice Address - Country:US
Practice Address - Phone:440-239-3438
Practice Address - Fax:440-239-3440
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH50001229363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant