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Individual

TANWI BAH TANWI IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 OLD WAGNER RD, SUITE 101, PETERSBURG, VA 23805-9313
(804) 524-2260
(804) 524-0096
Mailing address
601 OLD WAGNER RD, SUITE 101, PETERSBURG, VA 23805-9313
(804) 524-2260
(804) 524-0096

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101056856
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130019784
MEDICARE RAILROAD PIN
VA
05
7109741
VA
Enumeration date
05/11/2006
Last updated
07/07/2016
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