Provider Demographics
NPI:1568104016
Name:SRBU, SABRINA (PA-C)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:SRBU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16185 VIA MERA
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-1036
Mailing Address - Country:US
Mailing Address - Phone:586-457-0331
Mailing Address - Fax:
Practice Address - Street 1:2122 HEALTH DR SW STE 160
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9402
Practice Address - Country:US
Practice Address - Phone:616-252-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant