Provider Demographics
NPI:1891774576
Name:CABALAR, IMELDA P (MD)
Entity Type:Individual
Prefix:DR
First Name:IMELDA
Middle Name:P
Last Name:CABALAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11701 LIVINGSTON RD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:FT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5104
Mailing Address - Country:US
Mailing Address - Phone:301-203-0659
Mailing Address - Fax:
Practice Address - Street 1:11701 LIVINGSTON RD
Practice Address - Street 2:SUITE 309
Practice Address - City:FT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5104
Practice Address - Country:US
Practice Address - Phone:301-203-0659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068378207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H67137Medicare UPIN