Provider Demographics
NPI:1497857148
Name:SABBAGH, MOHAMMAD N (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:N
Last Name:SABBAGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5082 VILLA LINDE PKWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3411
Mailing Address - Country:US
Mailing Address - Phone:810-720-1335
Mailing Address - Fax:810-720-1373
Practice Address - Street 1:5082 VILLA LINDE PKWY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3411
Practice Address - Country:US
Practice Address - Phone:810-720-1335
Practice Address - Fax:810-720-1373
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMS0550972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3069438Medicaid
MI3069438Medicaid
MIOB56199002Medicare ID - Type Unspecified