Provider Demographics
NPI:1366411795
Name:SAYOC, EDGARDO M (MD)
Entity type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:M
Last Name:SAYOC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26706
Mailing Address - Street 2:SECTION #104
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-0706
Mailing Address - Country:US
Mailing Address - Phone:765-983-3033
Mailing Address - Fax:765-983-3044
Practice Address - Street 1:1401 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1908
Practice Address - Country:US
Practice Address - Phone:765-983-3033
Practice Address - Fax:765-983-3044
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026033A2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND70781Medicare UPIN
IN905450CMedicare ID - Type Unspecified