Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 998 | SD |
NPI | 1225276314 |
---|---|
Provider Name | Dr. John David Sabow |
First Address | Rapid City, SD 57709-5510 |
Second Address | Rapid City, SD 57701-8940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2009 |
Last Update Date | 27/01/2009 |