Individual
DR. EDWARD JAMES TANNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5275 LOUGHBORO RD NW BLDG D, WASHINGTON, DC 20016-2633
(202) 243-5295
(202) 537-4662
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
036147391
IL
207VX0201X
Gynecologic Oncology Physician
247219
NY
207VX0201X
Gynecologic Oncology Physician
D74316
MD
207VX0201X
Gynecologic Oncology Physician
Primary
MD500002320
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056633100
—
MD
Enumeration date
02/12/2007
Last updated
05/01/2024
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