Provider Demographics
NPI:1972506855
Name:ANSARI, SABA AZHER (MD)
Entity Type:Individual
Prefix:
First Name:SABA
Middle Name:AZHER
Last Name:ANSARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6442 CEDAR CREEK CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-226-3687
Mailing Address - Fax:513-336-6359
Practice Address - Street 1:6442 CEDAR CREEK CT
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-226-3687
Practice Address - Fax:513-336-6359
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2024-01-18
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
OH35081444208M00000X
OH35-08-1444207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2608280Medicaid
OH2565399Medicaid
OHP00284132OtherRAILROAD MEDICARE
KY64111867Medicaid
KY64111867Medicaid