Healthcare Provider Details

I. General information

NPI: 1841788247
Provider Name (Legal Business Name): SARIHA IMA MOYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 08/28/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WEST BOWERY STREET LEVEL 4
AKRON OH
44308
US

IV. Provider business mailing address

763 BRENTWOOD BLVD
COPLEY OH
44321-1479
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-8054
  • Fax:
Mailing address:
  • Phone: 330-285-7393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA185601
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number35.154333
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: