Provider Demographics
NPI:1467604801
Name:SABHARWAL, SAMMIT K (DO)
Entity Type:Individual
Prefix:DR
First Name:SAMMIT
Middle Name:K
Last Name:SABHARWAL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:23300 ECORSE ROAD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-1768
Mailing Address - Country:US
Mailing Address - Phone:313-291-9500
Mailing Address - Fax:586-263-2614
Practice Address - Street 1:18000 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48123-4089
Practice Address - Country:US
Practice Address - Phone:313-291-9500
Practice Address - Fax:586-263-2614
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2012-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1467604801Medicaid
12303863OtherCAHQ