1467571133 NPI number — EUGENE K SAWYER MD

Table of content: EUGENE K SAWYER MD (NPI 1467571133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467571133 NPI number — EUGENE K SAWYER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAWYER
Provider First Name:
EUGENE
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467571133
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5080 SPECTRUM DRIVE
Provider Second Line Business Mailing Address:
SUITE 1200 WEST TOWER
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75001-4648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-232-3550
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11100 METRO AIRPORT CENTER DR.
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ROMULUS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48174-5408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-778-4066
Provider Business Practice Location Address Fax Number:
615-778-9114
Provider Enumeration Date:
03/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083X0100X , with the licence number:  4301052492 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)