Provider Demographics
NPI:1376722173
Name:MILIND B. SANWARDEKER MD INC.
Entity type:Organization
Organization Name:MILIND B. SANWARDEKER MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MILIND
Authorized Official - Middle Name:B
Authorized Official - Last Name:SANWARDEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-492-5344
Mailing Address - Street 1:4850 HIGBEE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2528
Mailing Address - Country:US
Mailing Address - Phone:330-492-5344
Mailing Address - Fax:330-492-7369
Practice Address - Street 1:4850 HIGBEE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2528
Practice Address - Country:US
Practice Address - Phone:330-492-5344
Practice Address - Fax:330-492-7369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-10-0066-S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCL9883OtherRAILROAD MEDICARE
OH0335051Medicaid
OH000000130710OtherANTHEM
OH0335051Medicaid
OHA75799Medicare UPIN