Provider Demographics
NPI:1770029621
Name:SABAH INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:SABAH INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SABAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-877-1555
Mailing Address - Street 1:17633 WHITE PINE CT
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4358
Mailing Address - Country:US
Mailing Address - Phone:586-438-3535
Mailing Address - Fax:313-879-5533
Practice Address - Street 1:18263 E 10 MILE RD
Practice Address - Street 2:STE # D
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-5805
Practice Address - Country:US
Practice Address - Phone:586-438-3535
Practice Address - Fax:313-879-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty