Healthcare Provider Details

I. General information

NPI: 1205586690
Provider Name (Legal Business Name): SAHAR Q BAKHSH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 BENEDICT AVE
NORWALK OH
44857-2374
US

IV. Provider business mailing address

513 RED GINGER DR
SANDUSKY OH
44870-5044
US

V. Phone/Fax

Practice location:
  • Phone: 419-668-8110
  • Fax:
Mailing address:
  • Phone: 954-821-1630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.152803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: