Provider Demographics
NPI:1114008091
Name:SAWCHYN, ANDREA KNELLINGER (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:KNELLINGER
Last Name:SAWCHYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:ERIN
Other - Last Name:KNELLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8116
Mailing Address - Fax:614-293-3555
Practice Address - Street 1:915 OLENTANGY RIVER RD STE 5000
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3154
Practice Address - Country:US
Practice Address - Phone:614-293-8116
Practice Address - Fax:614-293-3555
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35094478207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3045538Medicaid
OHP01500555OtherRAILROAD MEDICARE
OHSA4293251Medicare PIN