Provider Demographics
NPI:1497702047
Name:NAWABI, KRISTEN P (MD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:P
Last Name:NAWABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:K
Other - Last Name:PFEIFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:171 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-2298
Practice Address - Country:US
Practice Address - Phone:843-792-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18121207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC181212Medicaid
NC89064UKMedicaid
99557OtherMEDCOST PIN
7995096OtherAETNA PIN
H128273365Medicare PIN
99557OtherMEDCOST PIN
SC181212Medicaid
7995096OtherAETNA PIN
060059464Medicare ID - Type UnspecifiedMEDICARE RAILROAD