Individual
MARIEN TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
201 DOCTORS DR, DOTHAN, AL 36301-2949
(334) 794-6611
(334) 794-6614
Mailing address
201 DOCTORS DR, DOTHAN, AL 36301-2949
(334) 794-6611
(334) 794-6614
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
235343
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2158078
—
MA
Enumeration date
01/15/2008
Last updated
05/30/2014
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