Individual
EDWARD C TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1445 PORTLAND AVE, SUITE 210, ROCHESTER, NY 14621
(585) 266-2583
(585) 266-5363
Mailing address
1445 PORTLAND AVE, SUITE 210, ROCHESTER, NY 14621
(585) 266-2583
(585) 266-5363
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1402751
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00593559
—
NY
01
—
102336C4
PREFERRED CARE
—
01
—
P010140275
BLUE CHOICE
—
Enumeration date
08/07/2006
Last updated
06/04/2009
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