Provider Demographics
NPI:1871688762
Name:N M SANSAIT MD LLC
Entity Type:Organization
Organization Name:N M SANSAIT MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOMEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:SANSAIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-548-6954
Mailing Address - Street 1:2738 PLEASANT COLONY DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8129
Mailing Address - Country:US
Mailing Address - Phone:740-548-6954
Mailing Address - Fax:
Practice Address - Street 1:8067 TOWNSHIP ROAD 334
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-9171
Practice Address - Country:US
Practice Address - Phone:740-815-8599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35764712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2129164Medicaid
OH40877943200OtherBWC
OHSA 0885854Medicare ID - Type Unspecified
OH2129164Medicaid