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General NPI Number Information
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NPI Number | 1538431028
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Entity Type | Organization
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Legal Business Name | RALPH TABIB MDPC
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 1145 1/2 FRANKLIN ST
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City | JOHNSTOWN
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State | PA
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Zip | 15905-4309
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Country | US
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Telephone | 814-539-2900
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Fax | 814-539-2900
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Provider Business Mailing Address
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Address Line | 1145 1/2 FRANKLIN ST
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City | JOHNSTOWN
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State | PA
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Zip | 15905-4309
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Country | US
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Telephone | 814-539-2900
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Fax | 814-539-2900
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | DR. RALPH TABIB
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Credential | MD
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Telephone | 814-539-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD063026L
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License Number State | PA
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