=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063417251
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANK MICHAEL SABO JR. M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2005
-----------------------------------------------------
Last Update Date | 11/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 KOLBE RD STE 100
-----------------------------------------------------
City | LORAIN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44053-1652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-233-8181
-----------------------------------------------------
Fax | 440-233-8182
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3600 KOLBE RD STE 100
-----------------------------------------------------
City | LORAIN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44053-1652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-233-8181
-----------------------------------------------------
Fax | 440-233-8182
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 35072566S
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------