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General NPI Number Information
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NPI Number | 1770029621
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Entity Type | Organization
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Legal Business Name | SABAH INTERNAL MEDICINE PLLC
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 18263 E 10 MILE RD STE # D
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City | ROSEVILLE
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State | MI
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Zip | 48066-5805
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Country | US
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Telephone | 586-438-3535
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Fax | 313-879-5533
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Provider Business Mailing Address
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Address Line | 17633 WHITE PINE CT
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City | NORTHVILLE
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State | MI
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Zip | 48168-4358
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Country | US
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Telephone | 586-438-3535
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Fax | 313-879-5533
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MOHAMMED SABAH
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Credential | M.D.
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Telephone | 810-877-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301076780
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License Number State | MI
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