Provider Demographics
NPI:1801016951
Name:EL SAYEGH, SAMAR SAID (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMAR
Middle Name:SAID
Last Name:EL SAYEGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4200 PARK AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004
Mailing Address - Country:US
Mailing Address - Phone:440-992-8552
Mailing Address - Fax:440-992-6631
Practice Address - Street 1:4200 PARK AVE
Practice Address - Street 2:2ND FLOOR THE NORTHCOAST CENTER
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004
Practice Address - Country:US
Practice Address - Phone:440-992-8552
Practice Address - Fax:440-992-6631
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350808152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2586938Medicaid
OH4110791Medicare UPIN