Organization
PENINSULA RENAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANTE J TAN MD (MEDICAL DIRECTOR)
(410) 742-1800
Entity
Organization
Contact information
Practice address
1340 SOUTH DIVISION STREET, STE 302, SALISBURY, MO 21804
(410) 742-1800
(410) 548-1288
Mailing address
1340 SOUTH DIVISION STREET, STE 302, SALISBURY, MO 21804
(410) 742-1800
(410) 548-1288
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
07/19/2006
Last updated
08/22/2020
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