Provider Demographics
NPI:1922086628
Name:SABA, CHRISTINE L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:SABA
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 1:15225 SHADY GROVE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3254
Mailing Address - Country:US
Mailing Address - Phone:301-838-8977
Mailing Address - Fax:301-838-0176
Practice Address - Street 1:15225 SHADY GROVE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3254
Practice Address - Country:US
Practice Address - Phone:301-838-8977
Practice Address - Fax:301-838-0176
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047734174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD302410500Medicaid