Individual
WALTER MANLEY TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
76 FREDERICK ST, TANEYTOWN, MD 21787-2135
(443) 974-0790
(410) 848-5785
Mailing address
5175 FEESER RD W, TANEYTOWN, MD 21787-2836
(443) 974-0790
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
MD
Other
Enumeration date
09/02/2024
Last updated
01/09/2026
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