Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101250115 | VA |
NPI | 1215116207 |
---|---|
Provider Name | Dr. Nicholas K Sablan |
First Address | Hampton, VA 23666-6249 |
Second Address | Hampton, VA 23666-6249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 14/07/2011 |