Provider Demographics
NPI:1457357113
Name:SAVANOOR, UMA (MD)
Entity Type:Individual
Prefix:
First Name:UMA
Middle Name:
Last Name:SAVANOOR
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 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:1220 E ELM ST
Practice Address - Street 2:SUITE 106
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2850
Practice Address - Country:US
Practice Address - Phone:419-226-5180
Practice Address - Fax:419-998-4517
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000199100OtherANTHEM COMMERICAL
OH080163253Medicaid
OH000000199100OtherANTHEM MEDICAID
OH2112163Medicaid
MI4256524Medicaid
MI4256524Medicaid
OHSA7279401Medicare PIN