Healthcare Provider Details

I. General information

NPI: 1184600652
Provider Name (Legal Business Name): CATHARINE J TABB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 11/03/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7325 SARATOGA HILLS DR NE
CANTON OH
44721-2724
US

IV. Provider business mailing address

7325 SARATOGA HILLS DR NE
CANTON OH
44721-2724
US

V. Phone/Fax

Practice location:
  • Phone: 330-388-9428
  • Fax: 330-388-9428
Mailing address:
  • Phone: 330-388-9428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number42588
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42588
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: