Provider Demographics
NPI:1144597238
Name:PERRY, TABITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:26005 RIDGE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-1899
Mailing Address - Country:US
Mailing Address - Phone:301-414-2300
Mailing Address - Fax:301-414-2306
Practice Address - Street 1:26005 RIDGE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-1899
Practice Address - Country:US
Practice Address - Phone:301-414-2300
Practice Address - Fax:301-414-2306
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0079628207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology