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Individual

VIRGINIA TAN TABIB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8127 MERRILLVILLE RD, MERRILLVILLE, IN 46410-6158
(219) 769-4855
(219) 757-5629
Mailing address
2600 ROOSEVELT RD, VALPARAISO, IN 46383-0970
(219) 464-1620
(219) 757-5629

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01032934
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100208820
IN
01
5171410004
DMERC
IN
Enumeration date
03/14/2006
Last updated
09/15/2008
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