Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 34.012546 | OH |
N | 207QS0010X | Family Doctor - Sports Medicine | OS 10487 | FL |
NPI | 1144471152 |
---|---|
Provider Name | Dr. Melissa Tabor |
First Address | Beachwood, OH 44122-4317 |
Second Address | Mayfield Hts, OH 44124-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2008 |
Last Update Date | 10/11/2016 |