1023060019 NPI number — DR. TANVEER GAIBI

Table of content: DR. TANVEER GAIBI (NPI 1023060019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023060019 NPI number — DR. TANVEER GAIBI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GAIBI
Provider First Name:
TANVEER
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023060019
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 631479
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21263-1479
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-293-0232
Provider Business Mailing Address Fax Number:
301-631-1002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
251 E ANTIETAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21740-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-313-9500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  0101254628 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: D0062650 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 408098000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00246416 . This is a "RAILROAD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 451601000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".