Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 35.136393 | OH |
Y | 207YS0123X | Facial Plastic Surgeon | 51186 | AZ |
N | 207YS0123X | Facial Plastic Surgeon | 52670 | KY |
N | 207YS0123X | Facial Plastic Surgeon | 88318 | MT |
N | 207YS0123X | Facial Plastic Surgeon | DR.0062407 | CO |
NPI | 1184036691 |
---|---|
Provider Name | Dr. Saba Ghorab |
First Address | Sidney, MT 59270-3521 |
Second Address | Scottsdale, AZ 85254-6169 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2014 |
Last Update Date | 30/08/2020 |