Organization
BRUCE J. SABIN MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN OVESEN (OFFICE MANAGER)
(770) 979-8022
Entity
Organization
Contact information
Practice address
1790 PRESIDENTIAL CIR, SUITE C, SNELLVILLE, GA 30078-5688
(770) 979-8022
(770) 979-1098
Mailing address
1790 PRESIDENTIAL CIR, SUITE C, SNELLVILLE, GA 30078-5688
(770) 979-8022
(770) 979-1098
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
031113
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110241661
RAILROAD MEDICARE
GA
01
—
130229
BLUE CROSS BLUE SHIELD
GA
Enumeration date
12/12/2006
Last updated
05/31/2012
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