MEDICARE: MICHAEL GEORGE SARIBALAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	36837	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164454211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL GEORGE SARIBALAS

Provider Business Mailing Address
First Line	:	4449 EASTON WAY FL 2
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-7005
Country	:	US
Telephone Number	:	614-532-5232
Fax Number	:	866-554-1848

Provider Business Practice Location Address
First Line	:	4449 EASTON WAY FL 2
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-7005
Country	:	US
Telephone Number	:	614-532-5232
Fax Number	:	866-554-1848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	11/09/2023

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