Provider Demographics
NPI:1528180825
Name:SABBAGH, AHMAD FIRAS (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:FIRAS
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 1:1031 PIERCE STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870
Mailing Address - Country:US
Mailing Address - Phone:419-557-5541
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:1221 HAYES AVE
Practice Address - Street 2:SUITE F
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3345
Practice Address - Country:US
Practice Address - Phone:419-557-6990
Practice Address - Fax:419-621-2202
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.88938207R00000X, 207RE0101X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2789728Medicaid
OH4211975Medicare PIN
OH4211974Medicare PIN
OH4211971Medicare PIN