Provider Demographics
NPI:1528177714
Name:YADAV, SANJAY (MD)
Entity type:Individual
Prefix:MR
First Name:SANJAY
Middle Name:
Last Name:YADAV
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-851-8469
Mailing Address - Fax:614-851-8528
Practice Address - Street 1:5141 W BROAD ST STE 130
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1984
Practice Address - Country:US
Practice Address - Phone:614-851-8469
Practice Address - Fax:614-851-8528
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084146174400000X
OH35.084146207RH0003X
OH35184146207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2527448Medicaid
OHH725310OtherMEDICARE
G60354Medicare UPIN