Provider Demographics
NPI:1710906607
Name:RENE, SABRINA M-Y (MD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:M-Y
Last Name:RENE
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 1:39 OAK HILL CT
Mailing Address - Street 2:BUILDING C
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2392
Mailing Address - Country:US
Mailing Address - Phone:770-683-7873
Mailing Address - Fax:770-683-7870
Practice Address - Street 1:39 OAK HILL CT
Practice Address - Street 2:BUILDING C
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2392
Practice Address - Country:US
Practice Address - Phone:770-683-7873
Practice Address - Fax:770-683-7870
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA046560207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000879392GMedicaid
GA000879392GMedicaid
GA46BBBGVMedicare PIN
GA006204Medicare PIN