Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 34003964 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 34003964 | OH |
N | 207QA0505X | Family Doctor - Adult Medicine | 34003964 | OH |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 34003964 | OH |
N | 208D00000X | General Practice Physician | 34003964 | OH |
NPI | 1649356304 |
---|---|
Provider Name | Madelyn Renee Sartain |
First Address | Dublin, OH 43016-0374 |
Second Address | Dublin, OH 43016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 05/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0592729 | (05) | OH |
E85655 | (02) | OH |