Healthcare Provider Details

I. General information

NPI: 1972506855
Provider Name (Legal Business Name): SABA AZHER ANSARI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date: 03/16/2006
Reactivation Date: 03/27/2006

III. Provider practice location address

6442 CEDAR CREEK CT
MASON OH
45040
US

IV. Provider business mailing address

6442 CEDAR CREEK CT
MASON OH
45040
US

V. Phone/Fax

Practice location:
  • Phone: 513-226-3687
  • Fax: 513-336-6359
Mailing address:
  • Phone: 513-226-3687
  • Fax: 513-336-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35081444
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number35-08-1444
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: