Basic Information
Provider Information
NPI: 1124450879
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAKR
FirstName: HANY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.,PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 20682 CENTURYWAY RD
Address2:  
City: MAPLE HEIGHTS
State: OH
PostalCode: 441373117
CountryCode: US
TelephoneNumber: 3185880022
FaxNumber:  
Practice Location
Address1: 410 W 10TH AVE
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432101240
CountryCode: US
TelephoneNumber: 6142933989
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2013
LastUpdateDate: 02/22/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XMD460010PAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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