Provider Demographics
NPI:1306856984
Name:SABLE, AARON WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:WAYNE
Last Name:SABLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13850 E 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-3730
Mailing Address - Country:US
Mailing Address - Phone:586-552-4499
Mailing Address - Fax:586-552-4878
Practice Address - Street 1:13850 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3730
Practice Address - Country:US
Practice Address - Phone:586-552-4499
Practice Address - Fax:586-552-4878
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301407605208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4447455Medicaid
E99587Medicare UPIN
MI4447455Medicaid