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Individual
MARK M. TAVAKOLI
Active
Individual
MARK M. TAVAKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6173
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00003018
—
AL
01
—
051549062
BCBS
AL
01
—
051549063
BCBS
AL
01
—
051549064
BCBS
AL
01
—
051594516
BCBS
AL
05
—
09259043
—
MS
05
—
101703
—
AL
05
—
101704
—
AL
05
—
101705
—
AL
05
—
105513
—
AL
01
—
C71588
VIVA
AL
01
—
P00653636
RAILROAD MEDICARE
AL
Enumeration date
06/28/2005
Last updated
11/04/2011
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