Individual
MARY CRAWFORD TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2630 E 7TH ST STE 200, CHARLOTTE, NC 28204-4319
(704) 364-6110
(704) 364-4245
Mailing address
2630 E 7TH ST STE 200, CHARLOTTE, NC 28204-4319
(704) 364-6110
(704) 364-4245
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001013531
NC
Other
Enumeration date
09/28/2023
Last updated
08/20/2024
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