Healthcare Provider Details

I. General information

NPI: 1316527872
Provider Name (Legal Business Name): SARAH M JOHNSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 HALE ST STE A
AVON OH
44011-1856
US

IV. Provider business mailing address

2535 HALE ST STE A
AVON OH
44011-1856
US

V. Phone/Fax

Practice location:
  • Phone: 440-934-8810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33307
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number58.032199
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: