Provider Demographics
NPI:1447493796
Name:CABRERA, SHARA ANN BETITO (MD)
Entity type:Individual
Prefix:DR
First Name:SHARA ANN
Middle Name:BETITO
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:875 OAK ST SE STE 4030
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3984
Mailing Address - Country:US
Mailing Address - Phone:503-561-6444
Mailing Address - Fax:
Practice Address - Street 1:3025 RYAN DR SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-5057
Practice Address - Country:US
Practice Address - Phone:503-540-9999
Practice Address - Fax:503-540-3105
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00917207RI0200X
ORMD182441207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1447493796OtherVA MCAID
NCQ0091ROtherSC MEDICAID
NC4193036OtherAETNA
NC5059274OtherUNITED HEALTHCARE
NC1447493796OtherTRICARE
NC1447493796Medicaid
NC1861LOtherBCBS
NC280968OtherMEDCOST
NCQ0091ROtherSC MEDICAID