Provider Demographics
NPI:1255871471
Name:SABELMAN, MATT
Entity type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:SABELMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20585 BRINSON BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-8741
Mailing Address - Country:US
Mailing Address - Phone:541-639-9993
Mailing Address - Fax:
Practice Address - Street 1:20585 BRINSON BLVD STE 4
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-8741
Practice Address - Country:US
Practice Address - Phone:541-639-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic