Tannenbaum, Mark A

Tannenbaum, Mark A is an individual health care provider with primary practice located at 5880 University Ave Ste. 102 , West Des Moines IA 50266-8220. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Tannenbaum, Mark A can be contacted via phone (515) 633-3600.

Contact Information

Primary practice address
5880 University Ave Ste. 102 West Des Moines IA 50266-8220
Phone: (515) 633-3600
Fax: (515) 288-0840
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 27144 Iowa
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 27144 Iowa

Profile Details

NPI number 1033191861
LBN Legal business name Tannenbaum, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Jun 14th, 2020 - about 4 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 1033191861 NPPES
Iowa MEDICAID 0057034

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