MEDICARE: DR. BRIANA MARIE TABLER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	10541	WV

General Provider Information

NPI Number	:	1356030555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIANA MARIE TABLER DPM

Provider Business Mailing Address
First Line	:	41 NEW THOMAS DR
Second Line	:
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-4822
Country	:	US
Telephone Number	:	304-279-5236
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 SOMERSET BLVD STE 101
Second Line	:
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-3954
Country	:	US
Telephone Number	:	304-725-2663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2023
Last Update Date	:	06/14/2026

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