Individual
IWAO K. TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT, PA 17701-3100
(570) 322-1161
(570) 322-2030
Mailing address
700 HIGH ST, WILLIAMSPORT, PA 17701-3100
(570) 322-1161
(570) 322-2030
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
245925
NY
2085R0202X
Diagnostic Radiology Physician
Primary
MD444860
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027220260001
—
PA
Enumeration date
07/13/2010
Last updated
11/01/2012
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