Individual
DR. JOAO O TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1645 WEST 8TH STREET, SHRINERS HOSPITALS FOR CHILDREN ERIE, ERIE, PA 16505-5097
(814) 875-8728
(814) 875-8796
Mailing address
PO BOX 8500, SHRINERS HOSPITALS FOR CHILDREN LOCKBOX #7642, PHILADELPHIA, PA 19178-7642
(813) 281-8478
(813) 281-8113
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
MD-034945-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0662516-02
—
PA
Enumeration date
02/16/2007
Last updated
09/27/2012
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