Physician Compare National (NPI:1154322659)

HEALTHCARE PROVIDER: THEODORE W TABER D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154322659
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133250368
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100701000429
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TABER
	Individual professional last name
Provider First Name	THEODORE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK CHIROPRACTIC COLLEGE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	TABER CHIROPRACTIC, PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6608907837
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4000 MITCHELLVILLE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A200
	Group Practice or individual's line 2 address
City	BOWIE
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	207163103
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3013524500
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y