Bruce Tabak, D.P.M.
Organization Active NPI Prosthetic/Orthotic Supplier · Oxford, MI
NPI 1093901795 · NPPES record last updated Jul 23, 2012
Key facts
- NPI
- 1093901795
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Prosthetic/Orthotic Supplier 335E00000X
- License
- 5901400128 (MI)
- Legal business name
- BRUCE TABAK, D.P.M.
- Practice address
- 129 S Washington St
Oxford, MI 48371-4981 - Phone
- (248) 628-1880
- Fax
- (248) 628-1881
- NPI assigned
- Sep 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Bruce Tabak, D.P.M.
- Title
- Owner
- Phone
- (248) 628-1880
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 5901400128 | MI | Yes |
Addresses
Primary practice location
129 S Washington St
Oxford, MI 48371-4981
Mailing address
129 S Washington St
Oxford, MI 48371-4981
Phone (248) 628-1880
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3142556 | Medicaid | MI |
Other providers in Oxford, MI
- Donald Alfred Bourbeau
- Alana Karie Koepf Bowman
- Erin Box
- Jessica Leah Bradford
- Kara Brook
- Scot William Bruce
- Brycon Wellness LLC
- Melissa Lynn Buck
- Jenna Budd
- Laurie Bueche
All providers in Oxford, MI · Prosthetic/Orthotic Supplier in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.