Tabak, Bruce
Tabak, Bruce is an sole proprietor health care provider with primary practice located at 129 S Washington St , Oxford MI 48371-4981. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Tabak, Bruce can be contacted via phone (248) 628-1880.Contact Information
Primary practice address
129 S Washington St
Oxford MI 48371-4981
Phone: (248) 628-1880
Fax: (248) 628-1881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 5901400128 | Michigan |
Profile Details
| NPI number | 1003988577 |
|---|---|
| LBN Legal business name | Tabak, Bruce |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Jul 23rd, 2012 - about 12 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 | 1003988577 | NPPES |
| Michigan | MEDICAID | 1648173 | |
| Michigan | MEDICAID | 3142556 | |
| Michigan | Other | 5635090 |
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