Provider Demographics
NPI:1639275860
Name:SABBAN, ELMARIE (MD)
Entity Type:Individual
Prefix:
First Name:ELMARIE
Middle Name:
Last Name:SABBAN
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 1:86229 N HAMPTON CLUB WAY
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-8137
Mailing Address - Country:US
Mailing Address - Phone:904-225-9008
Mailing Address - Fax:
Practice Address - Street 1:1463 NECTARINE ST
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-3027
Practice Address - Country:US
Practice Address - Phone:904-491-0177
Practice Address - Fax:904-491-3173
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79744208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics