Healthcare Provider Details

I. General information

NPI: 1508343765
Provider Name (Legal Business Name): SABER TADROS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 04/06/2023
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL CANCER INSTITUTE BUILDING 10, ROOM 3N248
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

10 CENTER DR BUILDING 10, ROOM 3N248
BETHESDA MD
20892-1500
US

V. Phone/Fax

Practice location:
  • Phone: 301-480-8856
  • Fax:
Mailing address:
  • Phone: 301-480-8856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberD0090292
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: