Healthcare Provider Details
I. General information
NPI: 1609968270
Provider Name (Legal Business Name): ANNMARIE D SABOVIK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/29/2006
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 NORTHPOINTE CIR SUITE 101
SEVEN FIELDS PA
16046-7851
US
IV. Provider business mailing address
100 NORTHPOINTE CIR SUITE 101
SEVEN FIELDS PA
16046-7851
US
V. Phone/Fax
- Phone: 724-772-0777
- Fax: 724-772-0050
- Phone: 724-772-0777
- Fax: 724-772-0050
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | OS013091 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1013019140001 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: