Healthcare Provider Details

I. General information

NPI: 1386468221
Provider Name (Legal Business Name): SABRINA AOUN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 W VERNOR HWY
DETROIT MI
48209-2180
US

IV. Provider business mailing address

5901 W VERNOR HWY
DETROIT MI
48209-2180
US

V. Phone/Fax

Practice location:
  • Phone: 313-554-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601012830
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: