Provider Demographics
NPI:1417923335
Name:KABAZIE, ABRAHAM JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:JOHN
Last Name:KABAZIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2257
Mailing Address - Country:US
Mailing Address - Phone:412-315-3800
Mailing Address - Fax:412-315-3801
Practice Address - Street 1:5124 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2257
Practice Address - Country:US
Practice Address - Phone:412-315-3800
Practice Address - Fax:412-315-3801
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058714L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2037932Medicaid
10929468OtherCAQH
PA001644853Medicaid
WV0062270000Medicaid
PA902173U31Medicare PIN