Provider Demographics
NPI:1578216032
Name:SAGUN, AMELIA (PA)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:SAGUN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 GOLDEN PL
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2463
Mailing Address - Country:US
Mailing Address - Phone:614-949-5661
Mailing Address - Fax:
Practice Address - Street 1:1124 E ELIZABETH ST STE C
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4051
Practice Address - Country:US
Practice Address - Phone:970-484-0798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant