Individual
DARRYL A TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
940 N MARR RD, SUITE C, COLUMBUS, IN 47201-2610
(812) 376-9353
(812) 376-3757
Mailing address
940 N MARR RD, SUITE C, COLUMBUS, IN 47201-2610
(812) 376-9353
(812) 376-3757
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1046006
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000195467
ANTHEM
IN
01
—
003842
SIHO
IN
01
—
200040850
RAILROAD MEDICARE
IN
05
—
200127230
—
IN
Enumeration date
06/29/2006
Last updated
01/04/2010
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