Provider Demographics
NPI:1649217183
Name:CAPITOL SLEEP MEDICINE, LLC
Entity Type:Organization
Organization Name:CAPITOL SLEEP MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UMA
Authorized Official - Middle Name:U
Authorized Official - Last Name:MARAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:613-317-9990
Mailing Address - Street 1:PO BOX 635281
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:614-317-9990
Mailing Address - Fax:614-317-9905
Practice Address - Street 1:2441 STRINGTOWN RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2926
Practice Address - Country:US
Practice Address - Phone:614-317-9990
Practice Address - Fax:614-317-9905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070329174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMA0806293Medicare ID - Type Unspecified
OHG31071Medicare UPIN
OHWA4032641Medicare ID - Type Unspecified
OHH24664Medicare UPIN