Tahboub, Imad
Tahboub, Imad is an individual health care provider with primary practice located at 215 Marion Ave , Mccomb MS 39648-2705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tahboub, Imad can be contacted via phone (601) 249-5500.Contact Information
Primary practice address
215 Marion Ave
Mccomb MS 39648-2705
Phone: (601) 249-5500
Fax: (601) 249-1173
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | IT053374 | Michigan |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 31196 | Alabama |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 23349 | Mississippi |
Profile Details
| NPI number | 1669468336 |
|---|---|
| LBN Legal business name | Tahboub, Imad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Apr 29th, 2021 - about 4 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 | 1669468336 | NPPES |
| Mississippi | MEDICAID | 03404537 | |
| Mississippi | MEDICAID | 131779 |
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