Provider Demographics
NPI:1427018837
Name:SABBAGH, ABDULMALEK (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDULMALEK
Middle Name:
Last Name:SABBAGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABDULAMALEK
Other - Middle Name:
Other - Last Name:SABBAGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:29 HOSPITAL PLZ
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-8470
Mailing Address - Country:US
Mailing Address - Phone:304-269-1448
Mailing Address - Fax:304-269-5235
Practice Address - Street 1:29 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-8471
Practice Address - Country:US
Practice Address - Phone:304-269-1448
Practice Address - Fax:304-269-5235
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV17371174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0075907000Medicaid
WVE71707Medicare UPIN