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Individual

DR. TANYA SUZANNE PRATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
930 3RD ST, GREENSBORO, NC 27405-6967
(336) 890-3200
(336) 890-3290
Mailing address
930 3RD ST, GREENSBORO, NC 27405-6967
(336) 890-3200
(336) 890-3290

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200300868
NC
207V00000X
Obstetrics & Gynecology Physician
Primary
200300868
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
134R8
BCBS NC
NC
01
3301
PARTNERS MEDICARE CHOICE
NC
01
7490
PARTNERS MEDICARE CHOICE
NC
01
7519483
AETNA
NC
05
89134R8
NC
01
C7390
MEDCOST
NC
01
D0470
MEDCOST
NC
Enumeration date
06/03/2006
Last updated
08/19/2021
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