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Individual

DR. ETA STEPHEN TATAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
7231 HANOVER PKWY STE A, GREENBELT, MD 20770-2027
(301) 982-7898
(301) 982-2588
Mailing address
7231 HANOVER PKWY STE A, GREENBELT, MD 20770-2027
(301) 982-7898
(301) 982-2588

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R178223
MD
363LF0000X
Family Nurse Practitioner
RN1011938
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
337807100
MD
05
424652700
MD
Enumeration date
09/10/2012
Last updated
02/24/2023
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