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Individual
DR. SARA R IRVIN
Active
Individual
DR. SARA R IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.088876
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000531312
ANTHEM MEDICAID
OH
05
—
2755513
—
OH
01
—
344428256
BEECH STREET
OH
05
—
5216120
—
MI
01
—
7025937
AETNA
OH
01
—
H437680
MEDICARE PTAN
OH
Enumeration date
05/23/2007
Last updated
11/05/2020
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