Provider Demographics
NPI:1609136811
Name:MBABIT, MARCELOS TAFON (MD)
Entity Type:Individual
Prefix:
First Name:MARCELOS
Middle Name:TAFON
Last Name:MBABIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7436 ALEXIS LN
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-5524
Mailing Address - Country:US
Mailing Address - Phone:317-652-2750
Mailing Address - Fax:
Practice Address - Street 1:7436 ALEXIS LN
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-5524
Practice Address - Country:US
Practice Address - Phone:317-652-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program