Tanenbaum, Mark P.

Tanenbaum, Mark P. is an individual health care provider with primary practice located at 3580 Joseph Siewick Dr Ste 305 , Fairfax VA 22033-1764. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Tanenbaum, Mark P. can be contacted via phone (703) 648-3266.

Contact Information

Primary practice address
3580 Joseph Siewick Dr Ste 305 Fairfax VA 22033-1764
Phone: (703) 648-3266
Fax: (703) 648-3264
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 0101043105 Virginia

Profile Details

NPI number 1114929247
LBN Legal business name Tanenbaum, Mark P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Aug 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114929247 NPPES
District of Columbia MEDICAID 031738500
District of Columbia Other 060035106
District of Columbia Other 060062627
District of Columbia MEDICAID 1114929247
District of Columbia MEDICAID 121300800

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