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Individual
SABA MADHOUN
Active
Individual
SABA MADHOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008284
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-2546610
BLUE CROSS BLUE SHIELD
MI
05
—
38-2546610
—
MI
Enumeration date
12/21/2015
Last updated
07/21/2022
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