Provider Demographics
NPI:1568462547
Name:TABB, MARVIN NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:NEIL
Last Name:TABB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3210 N LEISURE WORLD BLVD
Mailing Address - Street 2:# 103
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5698
Mailing Address - Country:US
Mailing Address - Phone:301-598-6289
Mailing Address - Fax:
Practice Address - Street 1:3416 OLANDWOOD CT
Practice Address - Street 2:SUITE 108
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1372
Practice Address - Country:US
Practice Address - Phone:301-774-7906
Practice Address - Fax:301-774-4350
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0010867208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics