MEDICARE: DIANA PATRICIA SABAGH SABAGH MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	051344	CT
2	2084P0804X	Child & Adolescent Psychiatry Physician	R8979	TX
3	2084P0804X	Child & Adolescent Psychiatry Physician	35.143647	OH

General Provider Information

NPI Number	:	1679891204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA PATRICIA SABAGH SABAGH MD

Provider Business Mailing Address
First Line	:	5010 MAYFIELD RD STE 304
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-2697
Country	:	US
Telephone Number	:	216-285-0724
Fax Number	:

Provider Business Practice Location Address
First Line	:	10524 EUCLID AVE STE 1155
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2205
Country	:	US
Telephone Number	:	216-844-3881
Fax Number	:

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

Provider Enumeration Date	:	05/06/2010
Last Update Date	:	07/09/2024

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