Provider Demographics
NPI:1487851994
Name:ROMEO H. TABBILOS, M.D.P.C.
Entity Type:Organization
Organization Name:ROMEO H. TABBILOS, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:H
Authorized Official - Last Name:TABBILOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-872-2740
Mailing Address - Street 1:3011 W GRAND BLVD
Mailing Address - Street 2:SUITE 428
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3096
Mailing Address - Country:US
Mailing Address - Phone:313-872-2740
Mailing Address - Fax:313-872-1875
Practice Address - Street 1:3011 W GRAND BLVD
Practice Address - Street 2:SUITE 428
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3096
Practice Address - Country:US
Practice Address - Phone:313-872-2740
Practice Address - Fax:313-872-1875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301031236207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty