Individual
ARDESHIR T. TAMBOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2814 PENNSYLVANIA AVE, WEIRTON, WV 26062-3719
(304) 723-1810
Mailing address
899 E IRON AVE STE D, DOVER, OH 44622-2097
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
12254
WV
207K00000X
Allergy & Immunology Physician
Primary
35045162T
OH
207K00000X
Allergy & Immunology Physician
MD036753L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112183000
—
WV
05
—
0433294
—
OH
05
—
101974726003
—
PA
01
—
P00469048
RR MEDICARE
OH
Enumeration date
07/07/2005
Last updated
02/23/2023
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