Provider Demographics
NPI:1245658905
Name:LI-SAUERWINE, SIMIAO (MD, MS)
Entity type:Individual
Prefix:DR
First Name:SIMIAO
Middle Name:
Last Name:LI-SAUERWINE
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:SIMIAO
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:376 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1280
Mailing Address - Country:US
Mailing Address - Phone:614-293-8305
Mailing Address - Fax:614-293-3124
Practice Address - Street 1:410 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-3905
Practice Address - Fax:614-293-3124
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125065382207P00000X
OH35133282207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine