Sandra Labalo, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301104821 Issued in MI

Practice address

22101 Moross Rd
Professional Building 2, Suite 50
Detroit, MI 48236-2148

Phone

(313) 343-7784

NPI assigned

May 5, 2014

Last updated

May 5, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Sandra Hadaya Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1518377126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17209 E JEFFERSON AVE",
            "address_2": "NONE",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301917",
            "telephone_number": "818-437-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "PROFESSIONAL BUILDING 2, SUITE 50",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABALO",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301104821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "HADAYA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Internal Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.