Individual
DR. SALLU M. JABATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3130 N ARIZONA AVE STE 112, CHANDLER, AZ 85225-7163
(480) 292-8579
(480) 306-6029
Mailing address
3908 SHADOW LOCH DR, SUWANEE, GA 30024-7455
(678) 559-4526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36200
AZ
208VP0014X
Interventional Pain Medicine Physician
36200
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299505
—
AZ
Enumeration date
02/21/2006
Last updated
09/14/2022
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