Provider Demographics
NPI:1518089291
Name:TABORI, KATHERINE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:TABORI
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-7000
Mailing Address - Fax:
Practice Address - Street 1:4810 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-8300
Practice Address - Country:US
Practice Address - Phone:336-547-8422
Practice Address - Fax:336-547-9482
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC134244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZR0000111Medicare UPIN