Provider Demographics
NPI:1831279413
Name:STABINSKY, SETH ALAN (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:ALAN
Last Name:STABINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-2500
Mailing Address - Country:US
Mailing Address - Phone:602-263-4232
Mailing Address - Fax:602-604-6582
Practice Address - Street 1:5651 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2500
Practice Address - Country:US
Practice Address - Phone:602-263-4232
Practice Address - Fax:602-604-6582
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47399207V00000X
CAG75569207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G755690Medicaid
CAE84606Medicare UPIN