Individual
DR. AUSTIN T TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-5741
(910) 907-8922
(910) 907-6069
Mailing address
2817 ROCK MERRITT AVE, FORT BRAGG, NC 28310-0001
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
93471
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
93471
MEDICAL LICENSE
GA
Enumeration date
06/15/2021
Last updated
07/16/2025
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