ALICE TANNER M.D.PC NPI 1013184159

NPI Information

NPI: 1013184159
Provider Name: ALICE TANNER M.D.,PC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
1406 CRAIN HWY S
SUITE 104
GLEN BURNIE, MD
ZIP 21061
Phone: (410) 768-2231
Get Directions

ALICE TANNER M.D.,PC is an adolescent medicine pediatrics in Glen Burnie, MD. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. ALICE TANNER M.D.,PC NPI is 1013184159. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1406 CRAIN HWY S
SUITE 104
GLEN BURNIE, MD
ZIP 21061-058
Phone: (410) 768-2231
Fax: (410) 760-4522

The provider's authorized official is Alice Patricia Tanner .
The authorized official title is Pediatrician/practice Owner and has the following contact phone number (410) 768-2231.

The enumeration date for this NPI number is 5/8/2008 and was last updated on 5/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	215896500	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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