Provider Demographics
NPI:1740664473
Name:SABIC, ALDIJAN (DPM)
Entity type:Individual
Prefix:DR
First Name:ALDIJAN
Middle Name:
Last Name:SABIC
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 N DOBSON RD STE 71
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4233
Mailing Address - Country:US
Mailing Address - Phone:480-963-9000
Mailing Address - Fax:480-963-0375
Practice Address - Street 1:595 N DOBSON RD STE 71
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-963-9000
Practice Address - Fax:480-963-0375
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD-000895213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ456818Medicaid