Provider Demographics
NPI:1528387032
Name:SAHORE, SHABETA (MD)
Entity Type:Individual
Prefix:
First Name:SHABETA
Middle Name:
Last Name:SAHORE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5525 RESEARCH PARK DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:248-668-8650
Mailing Address - Fax:248-668-8651
Practice Address - Street 1:41100 FOX RUN
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-4804
Practice Address - Country:US
Practice Address - Phone:248-668-8650
Practice Address - Fax:248-668-8651
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301097020207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine