Healthcare Provider Details

I. General information

NPI: 1295183747
Provider Name (Legal Business Name): DAVID SABBAGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 10TH ST STE D
PORT HURON MI
48060-5262
US

IV. Provider business mailing address

1209 10TH ST STE D
PORT HURON MI
48060-5262
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-8170
  • Fax:
Mailing address:
  • Phone: 810-985-8170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME172235
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301109767
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: