Individual
MATTHEW TANKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
125 LAKE VISTA DR, CHAPIN, SC 29036-8472
(678) 849-0923
Mailing address
125 LAKE VISTA DR, CHAPIN, SC 29036-8472
(678) 849-0923
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
268415
SC
Other
Enumeration date
05/22/2026
Last updated
05/22/2026
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