Individual
VAN E. TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4411 BEN FRANKLIN BLVD., DURHAM, NC 27704-2147
(919) 477-0047
(919) 477-6919
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(919) 477-6900
(919) 477-5081
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
103093
NC
Other
Enumeration date
08/05/2006
Last updated
07/08/2015
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