Provider Demographics
NPI:1801093356
Name:TABE, JULIUS TANYI V (MD)
Entity type:Individual
Prefix:DR
First Name:JULIUS
Middle Name:TANYI V
Last Name:TABE
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 1:8 HIAWATHA TRL
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-3320
Mailing Address - Country:US
Mailing Address - Phone:603-512-5659
Mailing Address - Fax:781-867-2040
Practice Address - Street 1:45 DAN RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2852
Practice Address - Country:US
Practice Address - Phone:781-867-2050
Practice Address - Fax:781-867-2040
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD19638207Q00000X
NH14979207Q00000X
MA242929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30209703Medicaid
NH1801093356OtherANTHEM BCBS
MA110086005Medicaid
NH1801093356OtherTRICARE
NH1801093356OtherTRICARE