Provider Demographics
NPI:1659647873
Name:KABBA, CHIDINMA DAWN (MD)
Entity type:Individual
Prefix:DR
First Name:CHIDINMA
Middle Name:DAWN
Last Name:KABBA
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 1:713 BERKELEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-7607
Mailing Address - Country:US
Mailing Address - Phone:917-915-2320
Mailing Address - Fax:
Practice Address - Street 1:5665 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1764
Practice Address - Country:US
Practice Address - Phone:678-843-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0080859207P00000X
VA0101260665207P00000X
COCDR.0001173207P00000X
AZ64240207P00000X
DEC1-0026891207P00000X
DCMD500003143.207P00000X
FLTMPE120207P00000X
GA78052207P00000X
IDMC-2737207P00000X
IL36.160582207P00000X
IN01088918A207P00000X
KS04-46233207P00000X
KYC0728207P00000X
AL42701207P00000X
CAC172381207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine