Provider Demographics
NPI:1689036535
Name:SABO, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SABO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5897 WINCHELL RD
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:OH
Mailing Address - Zip Code:44234-9785
Mailing Address - Country:US
Mailing Address - Phone:330-388-6247
Mailing Address - Fax:
Practice Address - Street 1:5897 WINCHELL RD
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:OH
Practice Address - Zip Code:44234-9785
Practice Address - Country:US
Practice Address - Phone:330-388-6247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2015265390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program