Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 35.141401 | OH |
NPI | 1003336140 |
---|---|
Provider Name | Dr. Kimberly Tamargo |
First Address | Detroit, MI 48277-1922 |
Second Address | Fairlawn, OH 44333-4510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2017 |
Last Update Date | 14/10/2021 |