Provider Demographics
NPI:1053990069
Name:SAKIBUZZAMAN, SAHIL MD (MD)
Entity type:Individual
Prefix:DR
First Name:SAHIL
Middle Name:MD
Last Name:SAKIBUZZAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MD
Other - Middle Name:
Other - Last Name:SAKIBUZZAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2130 W CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:419-291-3900
Mailing Address - Fax:419-479-6055
Practice Address - Street 1:2130 W CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-291-3900
Practice Address - Fax:419-479-6055
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-4348207R00000X
OH57.2532662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine