Provider Demographics
NPI:1598939027
Name:BABAR, TANIA B (MD)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:B
Last Name:BABAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MACCORKLE AVE SE STE 900
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1223
Mailing Address - Country:US
Mailing Address - Phone:304-388-5880
Mailing Address - Fax:304-388-5858
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 900
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1223
Practice Address - Country:US
Practice Address - Phone:304-388-5880
Practice Address - Fax:304-388-5858
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24078207RC0001X, 207R00000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810018108Medicaid
WVWV5885AOtherMEDICARE PTAN
WVWV5885AOtherMEDICARE PTAN