MEDICARE: SURAV MAN SAKYA 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207N00000X	Dermatology Physician	35.146995	OH

General Provider Information

NPI Number	:	1760060727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SURAV MAN SAKYA MD

Provider Business Mailing Address
First Line	:	2129 AUBURN AVE # 4-7
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7335 YANKEE RD STE 204
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-0006
Country	:	US
Telephone Number	:	513-579-9191
Fax Number	:

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

Provider Enumeration Date	:	03/31/2021
Last Update Date	:	03/19/2026

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Directions to “ SURAV MAN SAKYA MD” Practice Location

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