Individual
DR. SUSAN L TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3200 DOWNWOOD CIR NW, SUITE 520, ATLANTA, GA 30327-1610
(404) 845-7484
(404) 549-3005
Mailing address
3200 DOWNWOOD CIR NW, SUITE 520, ATLANTA, GA 30327-1610
(404) 845-7484
(404) 549-3005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25488
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582645783
FEDERAL TAX ID
GA
Enumeration date
04/20/2007
Last updated
02/10/2011
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