DR. LEE ERIC TANNENBAUM M.D. NPI 1528030004

NPI Information

  • NPI: 1528030004
  • Provider Name: DR. LEE ERIC TANNENBAUM, M.D.
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2012 S TOLLGATE RD
    STE 106
    BEL AIR, MD
    ZIP 21015
  • Phone: (410) 569-9429

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NPI Details

DR. Lee Eric Tannenbaum, M.D. is an addiction medicine family medicine in Bel Air, MD. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. DR. Lee Eric Tannenbaum, M.D. NPI is 1528030004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2012 S TOLLGATE RD
STE 106
BEL AIR, MD
ZIP 21015-900
Phone: (410) 569-9429
Fax: (410) 569-9423

The NPI 1528030004 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/7/2006 and was last updated on 5/22/2008.

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
1207QA0505XFamily MedicineAdult MedicineD39763MARYLANDNo
2207QA0401XFamily MedicineAddiction MedicineD39763MARYLANDYes

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
1927AMEDICARE ID-TYPE UNSPECIFIEDMARYLANDMEDICARE
2F00184MEDICARE UPINMARYLAND

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: 11/21/2025

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