Provider Demographics
NPI:1780682443
Name:ARBABI, KATHRYN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MARIE
Last Name:ARBABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 749363
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9363
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 E 3900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1300
Practice Address - Country:US
Practice Address - Phone:801-268-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10846473-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00434ROtherMEDICARE GRP PTAN
TX171381001Medicaid
TX171381001Medicaid
TXTXB130943Medicare PIN
TX00434ROtherMEDICARE GRP PTAN