Individual
TANBEENA IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 JOHN ST STE M-351, KALAMAZOO, MI 49007-5358
(269) 341-7784
Mailing address
601 JOHN ST STE M-351, KALAMAZOO, MI 49007-5358
(269) 341-7784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301116025
MI
2080P0206X
Pediatric Gastroenterology Physician
Primary
4301116025
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2012
Last updated
11/27/2023
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