Provider Demographics
NPI:1508802711
Name:MCGURRIN, SABRINA PLANTE (MD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:PLANTE
Last Name:MCGURRIN
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 1:1030 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2193
Mailing Address - Country:US
Mailing Address - Phone:901-523-8990
Mailing Address - Fax:901-522-3433
Practice Address - Street 1:1040 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104
Practice Address - Country:US
Practice Address - Phone:901-523-8990
Practice Address - Fax:901-522-3433
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233362207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1508802711Medicaid