Provider Demographics
NPI:1518118801
Name:SAHOTA, TEJINDER (DPM)
Entity Type:Individual
Prefix:
First Name:TEJINDER
Middle Name:
Last Name:SAHOTA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 KENT RD STE 150
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4424
Mailing Address - Country:US
Mailing Address - Phone:330-929-3331
Mailing Address - Fax:330-929-5408
Practice Address - Street 1:3226 KENT RD STE 150
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4424
Practice Address - Country:US
Practice Address - Phone:330-929-3331
Practice Address - Fax:330-929-5408
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-3562213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3140201Medicaid
OH3140201Medicaid
OH4320432Medicare PIN