Provider Demographics
NPI:1598908477
Name:SABA A CHUGHTAI LLC
Entity Type:Organization
Organization Name:SABA A CHUGHTAI LLC
Other - Org Name:SABA A CHUGHTAI MD & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SABA
Authorized Official - Middle Name:ATIQ
Authorized Official - Last Name:CHUGHTAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-234-7870
Mailing Address - Street 1:5740 GATEWAY
Mailing Address - Street 2:STE 104
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1893
Mailing Address - Country:US
Mailing Address - Phone:513-234-7870
Mailing Address - Fax:513-234-7836
Practice Address - Street 1:5740 GATEWAY
Practice Address - Street 2:SUITE 104
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1893
Practice Address - Country:US
Practice Address - Phone:513-234-7870
Practice Address - Fax:513-234-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2015-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2144103TC0700X
OH350825152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000614663OtherANTHEM
OH3011752Medicaid
OH000000614663OtherANTHEM
OHH28496Medicare UPIN
OH3011752Medicaid
OH9382821Medicare PIN