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NPI Code Detail

MEDICARE: SABA BAGEWADI M.D.

MEDICARE: SABA BAGEWADI M.D.
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
1208M00000XHospitalist PhysicianA169110CA
2208000000XPediatrics Physician00000000IL
3208000000XPediatrics PhysicianA169110CA

General Provider Information

NPI Number : 1588059059
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABA BAGEWADI M.D.
Provider Business Mailing Address
First Line : 15 HOSPITAL DR
Second Line :
City : YORK
State : ME
Zip : 03909-1011
Country : US
Telephone Number : 207-351-2478
Fax Number : 207-351-2216
Provider Business Practice Location Address
First Line : 1100 LARKSPUR LANDING CIR STE 10
Second Line :
City : LARKSPUR
State : CA
Zip : 94939-1836
Country : US
Telephone Number : 415-464-1350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2015
Last Update Date : 12/04/2025

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