Individual
TAMARA S HOUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3811 ED DR., SUITE 110, RALEIGH, NC 27612-8106
(919) 390-0200
(919) 390-0219
Mailing address
3811 ED DRIVE, SUITE 110, RALEIGH, NC 27612-8106
(919) 390-0200
(919) 390-0219
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
200001428
NC
207N00000X
Dermatology Physician
MD27163
OR
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
200001428
NC
207ND0101X
MOHS-Micrographic Surgery Physician
MD27163
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00443443
RR MEDICARE
OR
Enumeration date
09/27/2006
Last updated
10/19/2020
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