Provider Demographics
NPI:1437105095
Name:SABBAGH, COLETTE M (MD)
Entity Type:Individual
Prefix:DR
First Name:COLETTE
Middle Name:M
Last Name:SABBAGH
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 1:1002-C AMHERST STREET
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-662-3853
Mailing Address - Fax:540-662-0336
Practice Address - Street 1:1002-C AMHERST STREET
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-662-3853
Practice Address - Fax:540-662-3853
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014924208000000X
VA0101266610208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEH06620Medicare UPIN
MEMM8047Medicare ID - Type Unspecified