Healthcare Provider Details

I. General information

NPI: 1528362894
Provider Name (Legal Business Name): PAUL V SABY RPA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2010
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2292 PEACHTREE RD NW
ATLANTA GA
30309-1147
US

IV. Provider business mailing address

1872 HAMPTON GROVE WAY
DACULA GA
30019-1532
US

V. Phone/Fax

Practice location:
  • Phone: 404-996-0120
  • Fax: 404-351-6762
Mailing address:
  • Phone: 646-645-5183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number014541
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number8575
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: