Provider Demographics
NPI:1336593862
Name:SARIC, PETAR (MD)
Entity type:Individual
Prefix:
First Name:PETAR
Middle Name:
Last Name:SARIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 CLIFTON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3049
Mailing Address - Country:US
Mailing Address - Phone:513-246-4021
Mailing Address - Fax:513-861-5267
Practice Address - Street 1:3219 CLIFTON AVE STE 400
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3049
Practice Address - Country:US
Practice Address - Phone:513-246-4021
Practice Address - Fax:513-861-5267
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN67246207RC0000X
390200000X
OH35.135812207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program