# DR. HERBERT TISNOWER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1831195619
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD028686E | PA | — |
| 208D00000X | General Practice Physician | MD028686E | PA | Yes |

## Other

- **Enumeration date:** 06/25/2005
- **Last updated:** 09/09/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0009887700002 | — | PA |
| 01 | — | 0035661000 | PERSONAL CHOICE PPO OF PENNSYLVANIA (INDEPENDENT BLC) | PA |
| 01 | — | 0035661001 | PENNSYLVANIA KEYSTONE HEALTH PLAN EAST | PA |
| 01 | — | 080019943 | RAILROAD MEDICARE | PA |
| 01 | — | 1831195619 | KEYSTONE FIRST | PA |
| 01 | — | 232626909 | TRICARE PALMETTO (REGIONS 1-6) | PA |