Basic Information
Provider Information
NPI: 1164468484
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SASSO
FirstName: ROBERT
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 HOUGHTON AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486025303
CountryCode: US
TelephoneNumber: 9895836800
FaxNumber: 9895836955
Practice Location
Address1: 1000 HOUGHTON AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486025303
CountryCode: US
TelephoneNumber: 9895836800
FaxNumber: 9895836955
Other Information
ProviderEnumerationDate: 06/22/2006
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VE0102X8298NHN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
207VE0102X018303MEN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
207VG0400X018303MEN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
207VG0400X8298NHN Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
207VG0400X4301111273MIY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology

No ID Information.


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