Provider Demographics
NPI:1619942653
Name:SABETI, SHAHNAZ (DC)
Entity Type:Individual
Prefix:
First Name:SHAHNAZ
Middle Name:
Last Name:SABETI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3145
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46018-3145
Mailing Address - Country:US
Mailing Address - Phone:765-622-0600
Mailing Address - Fax:
Practice Address - Street 1:3003 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-1259
Practice Address - Country:US
Practice Address - Phone:765-622-0600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002038A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000321901OtherBC/BS
IN219360AMedicare ID - Type UnspecifiedMEDICARE #