Basic Information
| Provider Information | |||||||||
| NPI: | 1558528000 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SABO | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | PECK | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6035 FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282103256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 646 HARTNESS RD | ||||||||
| Address2: | |||||||||
| City: | STATESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286773423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048724108 | ||||||||
| FaxNumber: | 7048736517 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2008 | ||||||||
| LastUpdateDate: | 10/22/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | A108010 | CA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 2014-01705 | NC | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 30200419 | 01 | SC | SELECT HEALTH OF SC | OTHER | 189PN | 01 | NC | BCBSNC | OTHER | 8314433 | 01 | CIGNA | OTHER | 1506675 | 01 | COVENTRY | OTHER | Q0170E | 05 | SC | MEDICAID |