Provider Demographics
NPI:1932489002
Name:ABDUL JABBAR, SARAH (MBBS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ABDUL JABBAR
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIRCLE #2425
Mailing Address - Street 2:CENTRACARE CLINIC HEALTH PLAZA INTERNAL MEDICINE
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-229-4928
Mailing Address - Fax:320-229-4970
Practice Address - Street 1:1900 CENTRACARE CIRCLE #2425
Practice Address - Street 2:CENTRACARE CLINIC HEALTH PLAZA INTERNAL MEDICINE
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-229-4928
Practice Address - Fax:320-229-4970
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59050207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine