Individual
KATHRYN CABOT SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1109 BROOKDALE ST, SUITE C, MARTINSVILLE, VA 24112-4543
(276) 666-7545
(276) 632-0912
Mailing address
1109 BROOKDALE ST, SUITE C, MARTINSVILLE, VA 24112-4543
(276) 666-7545
(276) 632-0912
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101227849
VA
208000000X
Pediatrics Physician
7725550-8017
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811976319
—
UT
Enumeration date
01/12/2006
Last updated
07/26/2012
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