Provider Demographics
NPI:1528177284
Name:CABELL, KAREN S (DO)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:CABELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-5085
Mailing Address - Fax:208-625-5731
Practice Address - Street 1:2003 KOOTENAI HEALTH WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-6051
Practice Address - Country:US
Practice Address - Phone:208-625-5085
Practice Address - Fax:208-625-5731
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDO1024207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1153260003Medicare PIN
MTP00032404Medicare PIN
MT011000921Medicare PIN
WY118551900OtherMDCD PIN
MT000083403Medicare PIN
MT0062968OtherMDCD PIN
MT000094785OtherBCSB PIN
WYW2216Medicare PIN
MTH73659Medicare UPIN