Provider Demographics
NPI:1942596572
Name:KABRIEL, CHRISTOPHER-ALEX SCUKA (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER-ALEX
Middle Name:SCUKA
Last Name:KABRIEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PLEASANT ST.
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309
Mailing Address - Country:US
Mailing Address - Phone:515-241-5926
Mailing Address - Fax:515-241-5127
Practice Address - Street 1:1212 PLEASANT ST STE 300
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1412
Practice Address - Country:US
Practice Address - Phone:515-241-8923
Practice Address - Fax:515-241-8728
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04564208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics