Provider Demographics
NPI:1043245699
Name:MCCABE-KLINE, KRISTIN B (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:B
Last Name:MCCABE-KLINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:149 ISLAND ESTATES PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-2206
Mailing Address - Country:US
Mailing Address - Phone:386-864-7975
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:GREENVILLE MEMORIAL HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5611
Practice Address - Country:US
Practice Address - Phone:864-455-6372
Practice Address - Fax:864-455-5474
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27551207P00000X
FLME 98422207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC20-27551OtherSTATE CONTROLLED SUBST
SC172166OtherUNISON
FL94657OtherBCBS
SC275516Medicaid
SC275516Medicaid
SC275516Medicaid
SCI35282Medicare UPIN
SCAA0945Medicare PIN