Provider Demographics
NPI:1780887398
Name:SANBAR, SHAFEEK SANDY (MD)
Entity type:Individual
Prefix:DR
First Name:SHAFEEK
Middle Name:SANDY
Last Name:SANBAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-1108
Mailing Address - Country:US
Mailing Address - Phone:405-848-5325
Mailing Address - Fax:405-848-5325
Practice Address - Street 1:8100 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1108
Practice Address - Country:US
Practice Address - Phone:405-848-5325
Practice Address - Fax:405-848-5325
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9066207RC0000X, 209800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Not Answered209800000XAllopathic & Osteopathic PhysiciansLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE10989Medicare UPIN