Individual
MARY ELLEN SABOURIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Mailing address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32342-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083670277
—
WI
Enumeration date
04/25/2006
Last updated
04/05/2018
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