Healthcare Provider Details

I. General information

NPI: 1750725487
Provider Name (Legal Business Name): SAGGER HAMEED MAWRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 WYOMING STREET
DAYTON OH
45409
US

IV. Provider business mailing address

225 DUNN ST
HOUMA LA
70360-4440
US

V. Phone/Fax

Practice location:
  • Phone: 937-223-4461
  • Fax: 937-224-1945
Mailing address:
  • Phone: 985-876-0300
  • Fax: 985-876-5529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number322142
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number322142
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: