Provider Demographics
NPI:1497702047
Name:NAWABI, KRISTEN P (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:P
Last Name:NAWABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:K
Other - Last Name:PFEIFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1083 BOILING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-2298
Mailing Address - Country:US
Mailing Address - Phone:864-583-8647
Mailing Address - Fax:864-699-4179
Practice Address - Street 1:1083 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2298
Practice Address - Country:US
Practice Address - Phone:864-583-8647
Practice Address - Fax:864-699-4179
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18121207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89064UKMedicaid
SC181212Medicaid
99557OtherMEDCOST PIN
7995096OtherAETNA PIN
H128273365Medicare PIN
99557OtherMEDCOST PIN
SC181212Medicaid
7995096OtherAETNA PIN
060059464Medicare ID - Type UnspecifiedMEDICARE RAILROAD