Individual
TANYA MICHELLE PROWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, CRB186, BALTIMORE, MD 21205-2101
(410) 614-4459
Mailing address
PO BOX 64474, BALTIMORE, MD 21264-4474
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
D58507
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404979900
—
MD
Enumeration date
01/04/2007
Last updated
01/17/2014
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