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Individual

DR. JOHN P TABACCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5215 LOUGHBORO RD NW STE 440, WASHINGTON, DC 20016-2627
(202) 237-2912
Mailing address
5215 LOUGHBORO RD NW STE 440, WASHINGTON, DC 20016-2627
(202) 237-2912

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101256150
VA
207R00000X
Internal Medicine Physician
Primary
MD047655
DC
207R00000X
Internal Medicine Physician
ME116667
FL
207RS0010X
Sports Medicine (Internal Medicine) Physician
0101256150
VA
390200000X
Student in an Organized Health Care Education/Training Program
MD

Other

Enumeration date
06/08/2011
Last updated
11/07/2022
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