Individual
DR. CYRIL ETTA TABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 3RD AVE SW, MINOT, ND 58701-3880
(701) 857-3655
(701) 857-3656
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
10459
ND
208600000X
Surgery Physician
MD2009-0696
NM
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01089362A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
10459
ND
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
282203
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
C145282
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD2009-0696
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14089
—
ND
05
—
18307230
—
NM
Enumeration date
10/04/2006
Last updated
01/27/2023
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