Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 01036953A | IN |
NPI | 1053485367 |
---|---|
Provider Name | Dr. Dawn Marie Sabau |
First Address | Kokomo, IN 46904-2644 |
Second Address | Kokomo, IN 46902-3803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 05/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000345343 | ANTHEM (01) | IN |
100363150B | (05) | IN |
F54036 | (02) |