Provider Demographics
NPI:1639118268
Name:SACHS, EDWARD III (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:SACHS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 PARAGON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4041
Mailing Address - Country:US
Mailing Address - Phone:937-208-6920
Mailing Address - Fax:937-208-6948
Practice Address - Street 1:7707 PARAGON RD
Practice Address - Street 2:STE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4041
Practice Address - Country:US
Practice Address - Phone:937-208-6920
Practice Address - Fax:937-208-6948
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35031043S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0182636Medicaid
OHSA0776732Medicare PIN
OH0182636Medicaid