Provider Demographics
NPI:1205827078
Name:SHAHABUDDIN, SARAH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SHAHABUDDIN
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:PO BOX 8266
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-0266
Mailing Address - Country:US
Mailing Address - Phone:804-285-0100
Mailing Address - Fax:804-285-2458
Practice Address - Street 1:130 TEMPLE LAKE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-4902
Practice Address - Country:US
Practice Address - Phone:804-526-3450
Practice Address - Fax:804-520-1809
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231890207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA28581OtherCIGNA
VA4800892OtherUNITED HLTHCARE-MV
VA1014285OtherAETNA
VA154099OtherANTHEM-RICHMOND
VA154100OtherANTHEM-COLONIAL HEIGHTS
VA154101OtherANTHEM-MECHANICSVILLE
VA184465OtherSOUTHERN HEALTH
VA010184703Medicaid
VA4800408OtherUNITED HEALTHCARE-RICHMON
VA010184622Medicaid
VA010184746Medicaid
VA38371OtherCARENET
VA4800891OtherUNITED HEALTHCARE-CH
VA4800408OtherUNITED HEALTHCARE-RICHMON
VA154100OtherANTHEM-COLONIAL HEIGHTS