Individual
MS. TARA POMPONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2000 MEDICAL PKWY, SUITE 304, ANNAPOLIS, MD 21401-3742
(410) 573-9530
Mailing address
2000 MEDICAL PKWY STE 409, ANNAPOLIS, MD 21401-3746
(667) 204-7212
(443) 481-4151
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
CO4459
MD
363AM0700X
Medical Physician Assistant
PA18732
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
596754Y5Z
MEDICARE
MD
01
—
596754ZDWS
MEDICARE
MD
Enumeration date
01/16/2008
Last updated
12/27/2024
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