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Individual

TANGELA M GAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2001 MEDICAL PARKWAY, ACUTE CARE PAVILION, ANNAPOLIS, MD 21401-3280
(443) 481-6482
(443) 481-6515
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6569
(443) 481-6515

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C03729
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
607156012
US DEPT. OF LABOR
01
607156014
FEDERAL BLACK LUNG
Enumeration date
03/27/2007
Last updated
12/24/2013
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