Provider Demographics
NPI:1306843412
Name:SBAHI, SUBHI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBHI
Middle Name:
Last Name:SBAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18303 E 10 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4988
Mailing Address - Country:US
Mailing Address - Phone:586-776-8877
Mailing Address - Fax:586-776-3092
Practice Address - Street 1:18303 E 10 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4988
Practice Address - Country:US
Practice Address - Phone:586-776-8877
Practice Address - Fax:586-776-3092
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062674207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI127403OtherCARE CHOICES
MA5190207OtherAETNA
MI0E01050OtherBCBS
MI127403OtherMERCY HEALTH PLANS
MI4138351-10Medicaid
MI60054912OtherRAILROAD MEDICARE
MAM018365OtherCHAMPUS
MIP113708OtherBLUE CARE NETWORK
MAM018365OtherCHAMPUS
MIP113708OtherBLUE CARE NETWORK
MI4138351-10Medicaid