Provider Demographics
NPI:1497736029
Name:SABOTA, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:SABOTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 SIXTH ST SW
Mailing Address - Street 2:RM H2-672
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710-1702
Mailing Address - Country:US
Mailing Address - Phone:330-452-9911
Mailing Address - Fax:330-244-8521
Practice Address - Street 1:2600 SIXTH ST SW
Practice Address - Street 2:RM H2-672
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710-1702
Practice Address - Country:US
Practice Address - Phone:330-452-9911
Practice Address - Fax:330-244-8521
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2016-12-21
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Provider Licenses
StateLicense IDTaxonomies
OH35068031S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0272388Medicaid
OH110138759OtherRAILROAD MEDICARE
OHG09739Medicare UPIN