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Individual

MARYAM TABRIZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
501 W 14TH STREET, WILMINGTON, DE 19801-1013
(302) 320-4410
(785) 273-0524
Mailing address
200 HYGEIA DRIVE, SUITE 2300, NEWARK, DE 19713-2049
(785) 273-7571
(785) 273-0524

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04-37330
KS
208000000X
Pediatrics Physician
Primary
C1-0012410
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KA2129030
MEDICARE PTAN
KS
Enumeration date
04/22/2011
Last updated
12/26/2017
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