Individual
ISMAEL TAMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1901 HILLANDALE RD, SUITE D, DURHAM, NC 27705-2664
(919) 383-4355
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OT012068
PA
390200000X
Student in an Organized Health Care Education/Training Program
OT012068
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2010-01565
NC MEDICAL BOARD
NC
Enumeration date
07/17/2008
Last updated
05/03/2012
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