Provider Demographics
NPI:1831553528
Name:SABLABAN, IBRAHIM
Entity type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:
Last Name:SABLABAN
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 1:441 S MELBORN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1620
Mailing Address - Country:US
Mailing Address - Phone:773-225-0365
Mailing Address - Fax:
Practice Address - Street 1:2799 W. GRAND BLVD
Practice Address - Street 2:HENRY FORD HOSPITAL
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-874-6611
Practice Address - Fax:313-874-6655
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315076014183500000X
MI51010224462084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No183500000XPharmacy Service ProvidersPharmacist
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine