Taneous, Mary
Taneous, Mary is an individual health care provider with primary practice located at 1350 Walton Way , Augusta GA 30901-2612. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Taneous, Mary can be contacted via phone (706) 774-5400.Contact Information
Primary practice address
1350 Walton Way
Augusta GA 30901-2612
Phone: (706) 774-5400
Fax: (706) 774-5096
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 000346 | Georgia |
Profile Details
| NPI number | 1013984780 |
|---|---|
| LBN Legal business name | Taneous, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Jul 6th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013984780 | NPPES |
| Georgia | Other | 52212128 | BCBS |
| Georgia | Other | 58-1446543-001 | BCBS |
| Georgia | MEDICAID | 838631566A | BCBS |
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