Provider Demographics
NPI:1528233350
Name:SAGE, WILLIAM S
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:S
Last Name:SAGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5551 WILSON MILLS RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3251
Mailing Address - Country:US
Mailing Address - Phone:440-995-1770
Mailing Address - Fax:440-573-0057
Practice Address - Street 1:5551 WILSON MILLS RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-3251
Practice Address - Country:US
Practice Address - Phone:440-995-1770
Practice Address - Fax:440-573-0057
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0306798Medicaid
$$$$$$$$$00OtherOHIO BUREAU OF WORK COMP.
OH0306798Medicaid