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Individual
MR. JEFFREY DAVID TABER
Active
Individual
MR. JEFFREY DAVID TABER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33708
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112159
UCARE MINNESOTA
MN
05
—
135203200
—
MN
01
—
1506584
IA MEDICAID
MN
01
—
33246WI
BLUE CROSS BLUE SHIELD
MN
01
—
NA3221016530
PREFERRED ONE
MN
Enumeration date
08/12/2005
Last updated
12/12/2024
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