Healthcare Provider Details

I. General information

NPI: 1629068002
Provider Name (Legal Business Name): SABINE C IBEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # M-31
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-2417
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2567
  • Fax: 216-444-7625
Mailing address:
  • Phone: 216-407-6575
  • Fax: 216-844-3380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35070714I
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: