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Individual

RANA TAWIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4301 N STAR WAY, MODESTO, CA 95356-9262
(209) 577-1200
(209) 577-6517
Mailing address
4201 SAINT ANTOINE ST, 9 C, UHC, DETROIT, MI 48201-2153
(313) 745-5147

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301090773
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A112547
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301090773
MICHIGAN TEMPORARY LICENSE
MI
Enumeration date
07/29/2010
Last updated
07/21/2022
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