Individual
TANISHA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4C NORTH AVE STE 400, BEL AIR, MD 21014
(410) 638-0239
(410) 638-0282
Mailing address
4C NORTH AVE STE 400, BEL AIR, MD 21014-2333
(410) 638-0239
(410) 638-0282
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
15883
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407110364
—
NV
Enumeration date
06/26/2012
Last updated
09/25/2019
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