Provider Demographics
NPI:1447218706
Name:SABO, MATTHEW JAMES (DPM)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JAMES
Last Name:SABO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 MEDICAL CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CHICORA
Mailing Address - State:PA
Mailing Address - Zip Code:16025-2612
Mailing Address - Country:US
Mailing Address - Phone:724-445-3053
Mailing Address - Fax:724-445-3053
Practice Address - Street 1:176 MEDICAL CENTER RD
Practice Address - Street 2:
Practice Address - City:CHICORA
Practice Address - State:PA
Practice Address - Zip Code:16025-2612
Practice Address - Country:US
Practice Address - Phone:724-445-3053
Practice Address - Fax:724-455-3053
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC0047421213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000205717OtherANTHEM PROVIDER#
PA13914OtherELDER HEALTH PROVIDER#
PA251561562OtherGROUP#
PA251561562OtherRR MEDICARE PROVIDER#
PA56407OtherUNISON GROUP PROVIDER#
PA0018962330002Medicaid
PA132077OtherUNISON INDIVIDUAL #
PA1390124OtherINDIVIDUAL PROVIDER#
PA0011858030001Medicaid
PA188543OtherGROUP PROVIDER#
PA78203OtherAETNA GROUP PROVIDER#
PA7955556OtherAETNA INDIVIDUAL PROV #
PA827OtherHEALTH AMERICA GROUP#
PA318279OtherUPMC INDIVIDUAL PROVIDER#
PA200065OtherHEALTH AMERICA INDIVID#
PA318279OtherUPMC INDIVIDUAL PROVIDER#
PA251561562OtherRR MEDICARE PROVIDER#
PA0011858030001Medicaid