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Individual

STANLEY M TENENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1805 PARKE PLAZA CIR, STE 103, STONE MOUNTAIN, GA 30087
(770) 498-9355
(770) 498-6294
Mailing address
1805 PARKE PLAZA CIR, STE 103, STONE MOUNTAIN, GA 30087
(770) 498-9355
(770) 498-6294

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
011493
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00568972A
GA
Enumeration date
05/15/2006
Last updated
01/10/2014
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