Individual
DR. DIANE L TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
14300 GALLANT FOX LN, SUITE 201, BOWIE, MD 20715-4003
(301) 352-4500
Mailing address
14300 GALLANT FOX LN, SUITE 201, BOWIE, MD 20715-4003
(301) 352-4500
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01944
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
287091
MAMSI ID
MD
01
—
522247005
FEDERAL TAX ID
—
01
—
60608803
CAREFIRST MD REGION #
MD
01
—
LR25TA
CAREFIRST BCBS OF MD
MD
01
—
S2410001
CAREFIRST BC/BS
DC
Enumeration date
08/09/2005
Last updated
05/14/2010
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