Provider Demographics
NPI:1750337648
Name:PRADHAN, SABEENA (MD)
Entity type:Individual
Prefix:DR
First Name:SABEENA
Middle Name:
Last Name:PRADHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:360 E CHICAGO ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2074
Mailing Address - Country:US
Mailing Address - Phone:517-278-6929
Mailing Address - Fax:517-278-1810
Practice Address - Street 1:360 E CHICAGO ST
Practice Address - Street 2:SUITE F
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2074
Practice Address - Country:US
Practice Address - Phone:517-278-6929
Practice Address - Fax:517-278-1810
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MISP066447207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104833925Medicaid
MI104833925Medicaid
MIP28050001Medicare PIN