Tanner, Tina Louise

Tanner, Tina Louise is an individual health care provider with primary practice located at 2006 Holton Rd , Muskegon MI 49445-1505. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Tanner, Tina Louise can be contacted via phone (231) 672-3333.

Contact Information

Primary practice address
2006 Holton Rd Muskegon MI 49445-1505
Fax: (231) 672-3465
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301070365 Michigan

Profile Details

NPI number 1881645513
LBN Legal business name Tanner, Tina Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Feb 5th, 2019 - about 5 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 1881645513 NPPES
Michigan Other N28430 MEDICARE PTAN

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