Provider Demographics
NPI:1700892700
Name:SADOWSKI, EDMUND ZENON (MD)
Entity Type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:ZENON
Last Name:SADOWSKI
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 1:12000 MCCRACKEN RD STE 155
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2962
Mailing Address - Country:US
Mailing Address - Phone:216-663-3099
Mailing Address - Fax:216-663-3170
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:SUITE 155
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2964
Practice Address - Country:US
Practice Address - Phone:216-663-3099
Practice Address - Fax:216-663-3170
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1509286207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0752556Medicaid
OH0752556Medicaid