MEDICARE: DR. IMELDA P CABALAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	D0068378	MD

General Provider Information

NPI Number	:	1891774576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IMELDA P CABALAR M.D.

Provider Business Mailing Address
First Line	:	11701 LIVINGSTON RD
Second Line	:	SUITE 309
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-5104
Country	:	US
Telephone Number	:	301-203-0659
Fax Number	:

Provider Business Practice Location Address
First Line	:	11701 LIVINGSTON RD
Second Line	:	SUITE 309
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-5104
Country	:	US
Telephone Number	:	301-203-0659
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	03/02/2009

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