Provider Demographics
NPI:1558473140
Name:KABAWAT, SALIM E (MD)
Entity Type:Individual
Prefix:
First Name:SALIM
Middle Name:E
Last Name:KABAWAT
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 1:75 MOUNT AUBURN ST
Mailing Address - Street 2:HARVARD UNIVERSITY HEALTH SERVICES
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-4960
Mailing Address - Country:US
Mailing Address - Phone:617-496-8700
Mailing Address - Fax:617-495-6059
Practice Address - Street 1:75 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4960
Practice Address - Country:US
Practice Address - Phone:617-496-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42271207ZC0500X, 207ZI0100X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA54984Medicare UPIN
MAE05944Medicare ID - Type Unspecified