Individual
CLARENCE TABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
200 E 33RD ST, SUITE 487, BALTIMORE, MD 21218-3322
(410) 554-2780
Mailing address
8823 GREENS LN, RANDALLSTOWN, MD 21133-4205
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
1925
—
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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