Individual
DR. TANYA DEANNE CAMPUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 PARK ST, LAWRENCE, MA 01841-2517
(978) 685-1770
(978) 682-5787
Mailing address
150 PARK ST, LAWRENCE, MA 01841-2517
(978) 685-1770
(978) 682-5787
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
238352
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003968
ANTHEM
ME
01
—
0967149005
CIGNA
ME
05
—
290810099
—
ME
Enumeration date
02/28/2006
Last updated
10/09/2018
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