Provider Demographics
NPI:1710952619
Name:CABELL, CHRISTINE E (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:E
Last Name:CABELL
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 1:100 N ACADEMY AVE
Mailing Address - Street 2:CREDENTIALS DEPT
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:8 BROOKHILL SQUARE SOUTH
Practice Address - Street 2:
Practice Address - City:SUGARLOAF
Practice Address - State:PA
Practice Address - Zip Code:18249-1824
Practice Address - Country:US
Practice Address - Phone:570-459-0029
Practice Address - Fax:570-454-5757
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419134207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019008550001Medicaid
PA0019008550001Medicaid
PACO058360Medicare PIN