Provider Demographics
NPI:1053458315
Name:KABIR, KAROLYN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KAROLYN
Middle Name:K
Last Name:KABIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4099 E 10TH AVE UNIT 309
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3878
Mailing Address - Country:US
Mailing Address - Phone:303-594-6165
Mailing Address - Fax:
Practice Address - Street 1:4808 MOORLAND LN STE 109
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6131
Practice Address - Country:US
Practice Address - Phone:301-654-9476
Practice Address - Fax:301-654-1164
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37716208000000X, 2080A0000X, 208D00000X
VA0101272348208000000X, 2080A0000X, 208D00000X
MDD00912082080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1013042480OtherPRIVIA HEALTH
CO026262OtherKAISER COMMERCIAL NUMBER
CO31427359Medicaid
COCOA102817Medicare PIN