Provider Demographics
NPI:1194724534
Name:SABER, KATHY L (MD)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:L
Last Name:SABER
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:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:130-439-9440
Mailing Address - Fax:304-399-2526
Practice Address - Street 1:6475 FARMDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1321
Practice Address - Country:US
Practice Address - Phone:304-733-6333
Practice Address - Fax:304-733-6388
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0054593000Medicaid
WVG29929Medicare UPIN
WVSA0805184Medicare PIN