Diaban, Fatima Tahera
Diaban, Fatima Tahera is an sole proprietor health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is her primary health care specialty. Diaban, Fatima Tahera can be contacted via phone (920) 288-8000.Contact Information
Primary practice address
2845 Greenbrier Rd
Green Bay WI 54311-6519
Phone: (920) 288-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 5101020612 | Michigan |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 72292 | Wisconsin |
Profile Details
| NPI number | 1336586098 |
|---|---|
| LBN Legal business name | Diaban, Fatima Tahera |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 4th, 2013 |
| Last updated | Oct 3rd, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336586098 | NPPES |
| Wisconsin | MEDICAID | 100106465 |
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