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Individual
MARCELLA ANN TABOR
Active
Individual
MARCELLA ANN TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
368
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080107585
RR MEDICARE
SC
01
—
GP1551
MEDICAID GROUP
SC
01
—
SC2318I818
MEDICARE PIN
SC
05
—
T00656
—
SC
Enumeration date
04/28/2006
Last updated
04/03/2026
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