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ABILA VIOLET TAZANU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7401 FORBES BLVD STE A, LANHAM, MD 20706-2288
(301) 618-8395
(301) 618-8396
Mailing address
7401 FORBES BLVD STE A, LANHAM, MD 20706-2288
(301) 618-8395
(301) 618-8396

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
CS1100020
DC
208000000X
Pediatrics Physician
Primary
D0055053
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
685801500
MD
Enumeration date
06/20/2006
Last updated
03/17/2018
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