Individual
DR. MARC H TANENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1350 STUART ST, LONGMONT, CO 80501-3156
(303) 776-7300
(303) 776-7308
Mailing address
1350 STUART ST, LONGMONT, CO 80501-3156
(303) 776-7300
(303) 776-7308
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18430
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01184308
—
CO
Enumeration date
06/10/2006
Last updated
10/13/2010
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