Healthcare Provider Details

I. General information

NPI: 1811995277
Provider Name (Legal Business Name): CATHERINE M SARGENT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 COMMONS BLVD STE 120
BEAVERCREEK OH
45431-3827
US

IV. Provider business mailing address

2633 COMMONS BLVD STE 120
BEAVERCREEK OH
45431-3827
US

V. Phone/Fax

Practice location:
  • Phone: 937-427-8912
  • Fax: 937-702-9041
Mailing address:
  • Phone: 937-427-8912
  • Fax: 937-702-9041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34007228S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: