Individual
SARAH BETH SHUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
117 AUBURN ST, PORTLAND, ME 04103-6003
(207) 797-4791
(207) 317-5390
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
018045
ME
207X00000X
Orthopaedic Surgery Physician
A90230
CA
207X00000X
Orthopaedic Surgery Physician
M3461
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094NS
BCBS
TX
05
—
187028901
—
TX
Enumeration date
06/01/2005
Last updated
01/22/2021
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