Individual
ERIC S TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15225 SHADY GROVE RD, SUITE 201, ROCKVILLE, MD 20850-3254
(301) 670-3000
(301) 924-0186
Mailing address
15225 SHADY GROVE RD, SUITE 201, ROCKVILLE, MD 20850-3254
(301) 670-3000
(301) 924-0186
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0027886
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016713C83
MEDICARE PTAN
MD
05
—
383001200
—
MD
Enumeration date
06/19/2006
Last updated
04/23/2013
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