Provider Demographics
NPI:1871112185
Name:CHATHA, SABINA MAHMOOD
Entity type:Individual
Prefix:
First Name:SABINA
Middle Name:MAHMOOD
Last Name:CHATHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 WYNNEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-4754
Mailing Address - Country:US
Mailing Address - Phone:319-883-9050
Mailing Address - Fax:
Practice Address - Street 1:2834 ANSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-4418
Practice Address - Country:US
Practice Address - Phone:319-226-3514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist