Active NPI
Michael S Sabback, MD
- Surgery Physician
- Charleston, SC
National Provider Identifier
1124055298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- SC6699
- Practice address
- 9326 Medical Plaza Dr
Ste D
Charleston, SC 29406-9138 - Phone
- (843) 797-5353
- Fax
- (843) 797-6496
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | SC6699 | SC | Primary |
Addresses
Primary practice location
9326 Medical Plaza Dr
Ste D
Charleston, SC 29406-9138
Mailing address
9326 Medical Plaza Dr
Ste D
Charleston, SC 29406-9138
Phone (843) 797-5353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 066993 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC6699 | SC | MD | Surgery Physician |
| 6699 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1124055298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9326 MEDICAL PLAZA DR",
"address_2": "STE D",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294069138",
"telephone_number": "843-797-5353",
"fax_number": "843-797-6496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9326 MEDICAL PLAZA DR",
"address_2": "STE D",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294069138",
"telephone_number": "843-797-5353",
"fax_number": "843-797-6496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SABBACK",
"first_name": "MICHAEL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "SC6699",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066993",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.