Provider Demographics
NPI:1952376816
Name:ALSABBAGH, NINA (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:ALSABBAGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 HUGHES DR
Mailing Address - Street 2:STE 920
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3856
Mailing Address - Country:US
Mailing Address - Phone:419-479-2650
Mailing Address - Fax:419-479-2655
Practice Address - Street 1:2109 HUGHES DR
Practice Address - Street 2:STE 920
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3856
Practice Address - Country:US
Practice Address - Phone:419-479-2650
Practice Address - Fax:419-479-2655
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH77100207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000137371OtherANTHEM BCBS
03527OtherPARAMOUNT
OH2139993Medicaid
G12372Medicare UPIN
G12372Medicare UPIN