Individual
DR. TANVIR MAHTAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1466
(803) 531-6900
(803) 531-6907
Mailing address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1466
(803) 531-6900
(803) 531-6907
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
28238
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28238
SC LICENSE
SC
Enumeration date
05/01/2008
Last updated
11/29/2021
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