Provider Demographics
NPI:1972194496
Name:KABBES, GREGORY CHARLES
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:CHARLES
Last Name:KABBES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 ALICE FLAGG LN APT 202
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-8415
Mailing Address - Country:US
Mailing Address - Phone:919-622-1141
Mailing Address - Fax:
Practice Address - Street 1:3001 ALICE FLAGG LN APT 202
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-8415
Practice Address - Country:US
Practice Address - Phone:919-622-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program