Provider Demographics
NPI:1801009451
Name:SAADULLA, LAWAND A (MD)
Entity Type:Individual
Prefix:
First Name:LAWAND
Middle Name:A
Last Name:SAADULLA
Suffix:
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 1:36 TROY RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-4503
Mailing Address - Country:US
Mailing Address - Phone:614-483-9728
Mailing Address - Fax:740-994-9218
Practice Address - Street 1:4626 NADINE PARK DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-6079
Practice Address - Country:US
Practice Address - Phone:614-483-9728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD438312207R00000X, 207RN0300X
OH35097094207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3149284Medicaid
PA102461977Medicaid
PA102461977Medicaid
OHH031580Medicare PIN