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Individual

DAVID E TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
82 RED HILL RD, NEWPORT, PA 17074-8708
(717) 567-7884
Mailing address
82 RED HILL RD, P.O. BOX 10, NEWPORT, PA 17074-8708
(717) 567-7884

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OSOO4411L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005986020003
PA
01
01014602
CAPITAL BLUE CROSS
PA
01
080031059
PALMETTA GBA
PW
01
TA148070
HIGHMARK BLUE SHIELD
PA
Enumeration date
04/14/2006
Last updated
06/28/2010
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