Individual
DR. JAVAD TABATABAIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 PHILADELPHIA DR, SUITE 544, DAYTON, OH 45406-1830
(937) 277-5367
(937) 277-6919
Mailing address
PO BOX 41056, DAYTON, OH 45441
(937) 277-5367
(937) 277-6919
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35035392
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020993
ANTHEM
—
01
—
0403007
UHC
—
05
—
0836939
—
OH
Enumeration date
11/06/2006
Last updated
12/28/2009
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