Provider Demographics
NPI:1396708434
Name:TABET, MUNTHER S (MD)
Entity type:Individual
Prefix:DR
First Name:MUNTHER
Middle Name:S
Last Name:TABET
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:120 CHARLES ROLLINS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536
Mailing Address - Country:US
Mailing Address - Phone:252-436-0092
Mailing Address - Fax:252-436-0096
Practice Address - Street 1:120 CHARLES ROLLINS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536
Practice Address - Country:US
Practice Address - Phone:252-436-0092
Practice Address - Fax:252-436-0096
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC98-015232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891175KMedicaid
NCG38040Medicare UPIN
NC2266165BMedicare ID - Type UnspecifiedTABET MCR