Healthcare Provider Details

I. General information

NPI: 1508250986
Provider Name (Legal Business Name): OMAR SADIQ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6707 POWERS BLVD MEDICAL ARTS CNTR 2 STE 309
PARMA OH
44129-5455
US

IV. Provider business mailing address

6707 POWERS BLVD. SUITE 309 - MEDICAL ARTS CENTER II
PARMA OH
44129-5466
US

V. Phone/Fax

Practice location:
  • Phone: 440-886-5558
  • Fax:
Mailing address:
  • Phone: 440-886-5558
  • Fax: 440-886-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4301507267
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.145161
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: