Individual
TIM E TABER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BLVD, SUITE 4620, INDIANAPOLIS, IN 46202-5149
(317) 948-0505
(317) 948-3268
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01031282A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083030
ANTHEM NUMBER
IN
05
—
100193100
—
IN
Enumeration date
06/30/2005
Last updated
03/12/2025
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