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NPI Code Detail

MEDICARE: MS. ROBYN SAMIRA TABIBI MD

MEDICARE: MS. ROBYN SAMIRA TABIBI MD
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
1207Q00000XFamily Medicine Physician19617MN
2207Q00000XFamily Medicine Physician51292MN

General Provider Information

NPI Number : 1740216340
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROBYN SAMIRA TABIBI MD
Provider Business Mailing Address
First Line : 2025 SLOAN PL STE 35
Second Line :
City : SAINT PAUL
State : MN
Zip : 55117-2092
Country : US
Telephone Number : 651-772-1572
Fax Number : 651-772-1889
Provider Business Practice Location Address
First Line : 1385 PHALEN BLVD
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-2126
Country : US
Telephone Number : 651-776-2719
Fax Number : 651-771-3978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2006
Last Update Date : 07/13/2022

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