Individual
DAVID A TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5340 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1470
(574) 237-1328
(574) 237-1348
Mailing address
100 E WAYNE ST STE 510, SOUTH BEND, IN 46601-2349
(574) 334-5390
(574) 334-5368
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
01037563A
IN
207RX0202X
Medical Oncology Physician
Primary
01037563A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086655
ANTHEM-BCBS
IN
05
—
100091150A
—
IN
05
—
4827472
—
MI
Enumeration date
06/13/2005
Last updated
02/01/2018
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