Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 34824 | AZ |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD2016 0636 | NM |
NPI | 1215042973 |
---|---|
Provider Name | Evan B Taber |
First Address | Phoenix, AZ 85016-8034 |
Second Address | Phoenix, AZ 85008-4973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 07/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
995516 | (05) | AZ |