Individual
IRA ROY TANNEBAUM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1145 19TH ST NW, 313, WASHINGTON, DC 20036-3701
(202) 466-5837
(202) 466-5773
Mailing address
8624 WILD OLIVE DR, POTOMAC, MD 20854-3438
(301) 251-0099
(301) 251-4197
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD10031
DC
Other
Enumeration date
01/12/2006
Last updated
07/08/2007
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