Individual
FABIO ROCHA FERNANDES TAVORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 N BROADWAY ST, WEINBERG BLDG. SUITE 2242, BALTIMORE, MD 21287-0019
(410) 614-6330
(443) 287-3818
Mailing address
732 EASLEY ST, SILVER SPRING, MD 20910-4526
(301) 244-8433
(804) 836-1381
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
4301090336
MI
Other
Enumeration date
07/17/2007
Last updated
12/09/2009
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