Provider Demographics
NPI:1558528000
Name:SABO, RACHEL PECK (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:PECK
Last Name:SABO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:
Practice Address - Street 1:646 HARTNESS RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3423
Practice Address - Country:US
Practice Address - Phone:704-872-4108
Practice Address - Fax:704-873-6517
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108010207W00000X
NC2014-01705207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC30200419OtherSELECT HEALTH OF SC
NC189PNOtherBCBSNC
8314433OtherCIGNA
1506675OtherCOVENTRY
SCQ0170EMedicaid
SCQ0170EMedicaid