Tataw, Eta Stephen
Tataw, Eta Stephen is an individual health care provider with primary practice located at 7231 Hanover Pkwy Ste A , Greenbelt MD 20770-2027. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Tataw, Eta Stephen can be contacted via phone (301) 982-7898.Contact Information
Primary practice address
7231 Hanover Pkwy Ste A
Greenbelt MD 20770-2027
Phone: (301) 982-7898
Fax: (301) 982-2588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R178223 | Maryland |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN1011938 | District of Columbia |
Profile Details
| NPI number | 1821347592 |
|---|---|
| LBN Legal business name | Tataw, Eta Stephen |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 10th, 2012 |
| Last updated | Feb 24th, 2023 - about last year |
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 | 1821347592 | NPPES |
| Maryland | MEDICAID | 337807100 | |
| Maryland | MEDICAID | 424652700 |
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