Provider Demographics
NPI:1649659517
Name:BABIAK, KRISTEN ELAINE (DO)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELAINE
Last Name:BABIAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BRIDLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2101
Mailing Address - Country:US
Mailing Address - Phone:304-395-4148
Mailing Address - Fax:
Practice Address - Street 1:3110 MACCORKLE AVE SE
Practice Address - Street 2:ROOM 58
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1210
Practice Address - Country:US
Practice Address - Phone:304-388-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3431207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine