Provider Demographics
NPI:1568469849
Name:SARAH, AMAL (MD)
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:
Last Name:SARAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9313 S MASON MONTGOMERY RD
Mailing Address - Street 2:STE 250
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8008
Mailing Address - Country:US
Mailing Address - Phone:513-584-6898
Mailing Address - Fax:513-584-6897
Practice Address - Street 1:9313 S MASON MONTGOMERY RD
Practice Address - Street 2:STE 250
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-8008
Practice Address - Country:US
Practice Address - Phone:513-584-6898
Practice Address - Fax:513-584-6897
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35082978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00121281OtherMEDICARE RR
OH2468655Medicaid
OHP00121281OtherMEDICARE RR
OHH95673Medicare UPIN