Provider Demographics
NPI:1629068002
Name:IBEN, SABINE C (MD)
Entity Type:Individual
Prefix:
First Name:SABINE
Middle Name:C
Last Name:IBEN
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 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-2417
Mailing Address - Country:US
Mailing Address - Phone:216-407-6575
Mailing Address - Fax:216-844-3380
Practice Address - Street 1:9500 EUCLID AVE # M-31
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2567
Practice Address - Fax:216-444-7625
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070714I2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2102370Medicaid
OHH55056Medicare UPIN
OHIB4068412Medicare ID - Type Unspecified