Healthcare Provider Details

I. General information

NPI: 1730754037
Provider Name (Legal Business Name): SANA TYABUDDIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 POLARIS PKWY STE 230
WESTERVILLE OH
43082-7989
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-3475
  • Fax: 614-533-3480
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.018455
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: