1538359104 NPI number — DR. RASSAN M TARABEIN M.D.

Table of content: DR. RASSAN M TARABEIN M.D. (NPI 1538359104)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538359104 NPI number — DR. RASSAN M TARABEIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TARABEIN
Provider First Name:
RASSAN
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1538359104
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27535 US HIGHWAY 98
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAPHNE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36526-4839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-625-0909
Provider Business Mailing Address Fax Number:
251-380-7390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
27535 US HIGHWAY 98
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAPHNE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36526-4839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-625-0909
Provider Business Practice Location Address Fax Number:
251-380-7390
Provider Enumeration Date:
07/30/2007

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: 2084N0400X , with the licence number:  18124 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 529801790 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00033163 . This is a "MEDICARE RAILROAD FOLEY" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 358396601 . This is a "OWCP DAPHNE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 130017261 . This is a "MEDICARE RAILROAD DAPHNE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51506401 . This is a "BCBS FOLEY" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 5940140 . This is a "AETNA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 51034929 . This is a "BCBS DAPHNE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 0510010 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 721380230 36526 B001 . This is a "TRICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: J619 . This is a "MEDICARE GROUP" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 0510348 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 358396600 . This is a "OWCP FOLEY" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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