Individual
DR. ANTHONY JOHN TACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 NEW BERN AVE, NEONATOLOGY DEPT., RALEIGH, NC 27610-1231
(919) 350-8545
(919) 350-8146
Mailing address
3024 NEW BERN AVE, SUITE 300, RALEIGH, NC 27610-1247
(919) 350-8228
(919) 350-7976
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9901045
NC
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
9901045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912100
—
NC
Enumeration date
08/05/2006
Last updated
04/09/2010
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