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General NPI Number Information
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NPI Number | 1588816516
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Entity Type | Organization
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Legal Business Name | TEW A SAK MD PA
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 6719 GALL BLVD STE 107 TEW A SAK MD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-2568
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Country | US
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Telephone | 813-782-4113
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Fax | 813-788-2460
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Provider Business Mailing Address
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Address Line | 6719 GALL BLVD STE 107 TEW A SAK MD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-2568
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Country | US
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Telephone | 813-782-4113
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Fax | 813-788-2460
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TEW A SAK
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Credential | MD
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Telephone | 813-782-4113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME43869
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License Number State | FL
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