Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 34-011092 | OH |
N | 2080P0208X | Pediatric Infectious Diseases | DO034306 | DC |
NPI | 1114223344 |
---|---|
Provider Name | Dr. Sahera Dirajlal-Fargo |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2011 |
Last Update Date | 22/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0091785 | (05) | OH |