Provider Demographics
NPI:1689806119
Name:WELSH, SARA L (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:L
Last Name:WELSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LUZGARDA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6201 GENDER RD
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-2007
Mailing Address - Country:US
Mailing Address - Phone:614-834-8042
Mailing Address - Fax:614-837-8035
Practice Address - Street 1:6201 GENDER RD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2007
Practice Address - Country:US
Practice Address - Phone:614-834-8042
Practice Address - Fax:614-837-8035
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35097549208000000X, 208M00000X
OH35.097549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0079585Medicaid