Provider Demographics
NPI:1003043381
Name:SABETI, RITA (MD)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:SABETI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12868 W BLUEMOUND RD
Mailing Address - Street 2:
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2605
Mailing Address - Country:US
Mailing Address - Phone:414-616-3935
Mailing Address - Fax:
Practice Address - Street 1:12868 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2605
Practice Address - Country:US
Practice Address - Phone:414-616-3935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56179-20208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice