Provider Demographics
NPI:1801862248
Name:SABAL, NANCY (DO)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:SABAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23050 WEST RD
Mailing Address - Street 2:SUITE 130 ATTN DENISE GOMOLL
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1473
Mailing Address - Country:US
Mailing Address - Phone:734-671-1404
Mailing Address - Fax:734-391-3052
Practice Address - Street 1:2070 BIDDLE AVE STE 2
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4080
Practice Address - Country:US
Practice Address - Phone:734-671-6741
Practice Address - Fax:734-671-1038
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H27501OtherBLUE CROSS
1841564788OtherGROUP NPI HENRY FORD WYANDOTTE
MI0H27501OtherBLUE CROSS
MIMI5491013Medicare PIN