MEDICARE: LAURIE L SABINE 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
1	207Q00000X	Family Medicine Physician	35048001	OH
2	207Q00000X	Family Medicine Physician	35.048001	OH

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	:	1629055165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE L SABINE M.D.

Provider Business Mailing Address
First Line	:	5334 MEADOW LANE COURT
Second Line	:
City	:	SHEFFIELD VILLAGE
State	:	OH
Zip	:	44035-1469
Country	:	US
Telephone Number	:	440-934-5454
Fax Number	:	440-934-8999

Provider Business Practice Location Address
First Line	:	5334 MEADOW LANE COURT
Second Line	:
City	:	SHEFFIELD VILLAGE
State	:	OH
Zip	:	44035-1469
Country	:	US
Telephone Number	:	440-934-5454
Fax Number	:	440-934-8999

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

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	08/01/2012

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