Provider Demographics
NPI:1528346566
Name:NICHOLAS, SARA ASHLEY (DO)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:ASHLEY
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2031 BELMONT AVE STE B
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2401
Mailing Address - Country:US
Mailing Address - Phone:330-480-3033
Mailing Address - Fax:330-480-2568
Practice Address - Street 1:2031 BELMONT AVE STE B
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2401
Practice Address - Country:US
Practice Address - Phone:330-480-3033
Practice Address - Fax:330-480-2568
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101019424207V00000X
OH34.011662207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150587Medicaid