Individual
DR. JEFFREY JAY TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2605 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6475
(919) 881-9009
(919) 881-8463
Mailing address
2605 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6475
(919) 881-9009
(919) 881-8463
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39114
NC
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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