Individual
DR. JUSTIN TANNIR
Active
Individual
DR. JUSTIN TANNIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301092763
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301092763
STATE LICENSE
MI
Enumeration date
01/30/2008
Last updated
05/28/2020
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