Healthcare Provider Details

I. General information

NPI: 1396709101
Provider Name (Legal Business Name): CAMILLE SABELLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # R3
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # DESKR3
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-6862
  • Fax: 216-636-3405
Mailing address:
  • Phone: 216-445-6862
  • Fax: 216-636-3405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number35057798
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: