Provider Demographics
NPI:1669456562
Name:SAHLANI, KAMAL
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:
Last Name:SAHLANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3619
Mailing Address - Country:US
Mailing Address - Phone:440-449-0636
Mailing Address - Fax:
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 534
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-261-0000
Practice Address - Fax:216-261-0001
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055310207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0674417Medicaid
OH0604634Medicare ID - Type Unspecified
OHA17100Medicare UPIN