Healthcare Provider Details

I. General information

NPI: 1043906712
Provider Name (Legal Business Name): SARAH R KIRABO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 KINGS ISLAND DR
MASON OH
45040-7931
US

IV. Provider business mailing address

4600 MCAULEY PL
BLUE ASH OH
45242-4733
US

V. Phone/Fax

Practice location:
  • Phone: 513-981-5820
  • Fax:
Mailing address:
  • Phone: 513-952-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.156373
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: