Organization
ALICE TANNER M.D.,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICE PATRICIA TANNER M.D. (PEDIATRICIAN/PRACTICE OWNER)
(410) 768-2231
Entity
Organization
Contact information
Practice address
1406 CRAIN HWY S, SUITE 104, GLEN BURNIE, MD 21061-4058
(410) 768-2231
(410) 760-4522
Mailing address
1406 CRAIN HWY S, SUITE 104, GLEN BURNIE, MD 21061-4058
(410) 768-2231
(410) 760-4522
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215896500
—
MD
Enumeration date
05/08/2008
Last updated
05/08/2008
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