Provider Demographics
NPI:1649459983
Name:ELSAYED, SAMI SID AHMED (MD)
Entity type:Individual
Prefix:
First Name:SAMI
Middle Name:SID AHMED
Last Name:ELSAYED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 NILES CORTLAND RD NE STE X
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1055
Mailing Address - Country:US
Mailing Address - Phone:330-306-5371
Mailing Address - Fax:330-306-5311
Practice Address - Street 1:1932 NILES CORTLAND RD NE STE X
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1055
Practice Address - Country:US
Practice Address - Phone:330-306-5371
Practice Address - Fax:330-306-5311
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0942662085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH303107OtherOHIO MEDICAID UNISON
OH3055778Medicaid
OHP00828566OtherRAILROAD MEDICARE
OH3055778OtherOHIO MEDICAID MOLINA
OH310917085236OtherOHIO MEDICAID CARESOURCE
WV3810017700Medicaid
OH4289901Medicare PIN
WV4289902Medicare PIN