Individual
DR. ETHAN ALI TABAIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
417 N 11TH ST, RICHMOND, VA 23298-5024
(804) 828-9165
(804) 828-4493
Mailing address
PO BOX 980257, RICHMOND, VA 23298-0257
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0116041995
VA
207T00000X
Neurological Surgery Physician
Primary
Y3980256
CA
Other
Enumeration date
03/11/2025
Last updated
06/25/2026
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