Dr. Bruce Tabak
Podiatrist
129 S Washington St
Oxford
, Michigan 48371-4981
Dr. Bruce Tabak
Podiatrist
129 S Washington St
Oxford
, Michigan 48371-4981
(248) 628-1881
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About
Features
Specialties
- Podiatrist
Languages spoken
- English
Location
First Address
- Dr. Bruce Tabak
- 129 S Washington St
- Oxford, MI
- Zip : 48371-4981
- Fax : (248) 628-1881
- Phone : (248) 628-1880
Second Address
- Dr. Bruce Tabak
- 129 S Washington St
- Oxford, MI
- Zip : 48371-4981
- Fax : (248) 628-1881
- Phone : (248) 628-1880
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 5901400128 | MI |
| Y | 222Z00000X | Podiatrist | 5901400128 | MI |
National Provider Identifier
| NPI | 1003988577 |
|---|---|
| Provider Name | Dr. Bruce Tabak |
| First Address | Oxford, MI 48371-4981 |
| Second Address | Oxford, MI 48371-4981 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/11/2006 |
| Last Update Date | 23/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1648173 | (05) | MI |
| 3142556 | (05) | MI |
| 5635090 | BLUE CROSS OF MICHIGAN (01) | MI |
| T34146 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.