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Individual

MARCELLA ANN TABOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1213 REMOUNT RD, NORTH CHARLESTON, SC 29406-3433
(843) 973-5415
(833) 994-1101
Mailing address
1213 REMOUNT RD, NORTH CHARLESTON, SC 29406-3433
(843) 973-5415
(833) 994-1101

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
368
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080107585
RR MEDICARE
SC
01
GP1551
MEDICAID GROUP
SC
01
SC2318I818
MEDICARE PIN
SC
05
T00656
SC
Enumeration date
04/28/2006
Last updated
04/03/2026
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