MEDICARE: DR. KENNETH J SABLE DC

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	111N00000X	Chiropractor	01765	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R7260001	OTHER	MD	BCBS OF DC
2	M440	OTHER	MD	BCBS OF MD

General Provider Information

NPI Number	:	1427123801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH J SABLE DC

Provider Business Mailing Address
First Line	:	3261 OLD WASHINGTON RD
Second Line	:	SUITE 2010
City	:	WALDORF
State	:	MD
Zip	:	20602-3223
Country	:	US
Telephone Number	:	301-645-5390
Fax Number	:	301-645-6215

Provider Business Practice Location Address
First Line	:	3261 OLD WASHINGTON RD
Second Line	:	SUITE 2010
City	:	WALDORF
State	:	MD
Zip	:	20602-3223
Country	:	US
Telephone Number	:	301-645-5390
Fax Number	:	301-645-6215

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	06/18/2008

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Directions to “ DR. KENNETH J SABLE DC” Practice Location

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