Individual
ALI TABATABAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6704
(410) 328-4124
Mailing address
PO BOX 64793, BALTIMORE, MD 21264-4793
(410) 328-6704
(410) 328-4124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D66267
MD
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D66267
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412785400
—
MD
Enumeration date
02/21/2007
Last updated
04/14/2010
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