Provider Demographics
NPI:1912585233
Name:TAHBOUB, RAWAN YAHYA REBHI (MD)
Entity Type:Individual
Prefix:
First Name:RAWAN
Middle Name:YAHYA REBHI
Last Name:TAHBOUB
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 1:1 INNOVATION DR
Mailing Address - Street 2:BIOTECH 3
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-4306
Mailing Address - Country:US
Mailing Address - Phone:508-334-1000
Mailing Address - Fax:
Practice Address - Street 1:1 INNOVATION DR
Practice Address - Street 2:BIOTECH 3
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-4306
Practice Address - Country:US
Practice Address - Phone:508-334-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program