Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Paul Tabor, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1740719640

Charles Paul Tabor, MD is a Family Practice in Grand Rapids, Minnesota. Qualified in 2017, 9 years ago. Practices with Grand Itasca Clinic and Hospital, a 325-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone: (218) 999-1911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 1740719640 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 64365 (MN)

Record details

NPI number1740719640
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2017
Last updated in NPPESNovember 12, 2021
Certification dateSeptember 1, 2021
Mailing address1601 Golf Course Rd, Grand Rapids, MN 55744-8648

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Grand Itasca Clinic And Hospital — 325 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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