Tabor, Brent Eric

Tabor, Brent Eric is an individual health care provider with primary practice located at 702 Russell Ave Suite 103, Gaithersburg MD 20877-2606. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Tabor, Brent Eric can be contacted via phone (301) 948-3668.

Contact Information

Primary practice address
702 Russell Ave Suite 103 Gaithersburg MD 20877-2606
Phone: (301) 948-3668
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 01195 Maryland

Profile Details

NPI number 1841276037
LBN Legal business name Tabor, Brent Eric
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Feb 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841276037 NPPES
Maryland MEDICAID 218838400

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