Provider Demographics
NPI:1306564026
Name:SABIR, KHALID A
Entity type:Individual
Prefix:MR
First Name:KHALID
Middle Name:A
Last Name:SABIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16321 LORAIN AVE APT 610
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5548
Mailing Address - Country:US
Mailing Address - Phone:312-477-6756
Mailing Address - Fax:
Practice Address - Street 1:29201 AURORA RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-1846
Practice Address - Country:US
Practice Address - Phone:800-577-2054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAP.003478175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPS.003478OtherMHSA