Tenenbaum, Stanley M
Tenenbaum, Stanley M is an individual health care provider with primary practice located at 1805 Parke Plaza Cir Ste 103, Stone Mountain GA 30087. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Tenenbaum, Stanley M can be contacted via phone (770) 498-9355.Contact Information
Primary practice address
1805 Parke Plaza Cir Ste 103
Stone Mountain GA 30087
Phone: (770) 498-9355
Fax: (770) 498-6294
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 011493 | Georgia |
Profile Details
| NPI number | 1316998255 |
|---|---|
| LBN Legal business name | Tenenbaum, Stanley M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Jan 10th, 2014 - 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 | 1316998255 | NPPES |
| Georgia | MEDICAID | 00568972A |
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