Healthcare Provider Details

I. General information

NPI: 1366854879
Provider Name (Legal Business Name): SARAH WATSON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 STATION ST STE 270
MENTOR OH
44060-4943
US

IV. Provider business mailing address

8500 STATION ST
MENTOR OH
44060-4943
US

V. Phone/Fax

Practice location:
  • Phone: 440-641-4146
  • Fax: 440-596-4633
Mailing address:
  • Phone: 440-641-4146
  • Fax: 440-596-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34C.000345
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: