MEDICARE: SAURABH BANSAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	35095031	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508172321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAURABH BANSAL MD

Provider Business Mailing Address
First Line	:	805 COLUMBIA RD STE 109
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1461
Country	:	US
Telephone Number	:	440-799-4224
Fax Number	:	440-799-4228

Provider Business Practice Location Address
First Line	:	805 COLUMBIA RD STE 101
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1461
Country	:	US
Telephone Number	:	216-228-5500
Fax Number	:	216-227-2628

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2010
Last Update Date	:	04/29/2026

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