Individual
DR. MIEKO TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
955 FAIRFIELD RD, FAYETTEVILLE, NC 28303-5358
(910) 323-9196
(910) 323-9867
Mailing address
955 FAIRFIELD RD, FAYETTEVILLE, NC 28303-5358
(910) 323-9196
(910) 323-9867
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
4646
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12393
BCBS
NC
05
—
3404172
—
NC
01
—
89569
MEDCOST
NC
Enumeration date
08/17/2005
Last updated
09/05/2007
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