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Shlomo Mark Tanen, MD
Specialist in Potomac, Maryland
NPI 1174562540

Shlomo Mark Tanen is a Specialist based in Potomac, MD. Shlomo Mark Tanen practices in Potomac, MD and has the professional credentials of MD. The NPI Number for Shlomo Mark Tanen is 1174562540 and holds a License No. 0130000215 (Maryland).

The current practice location address for Shlomo Mark Tanen is 11702 Gainsborough Rd, Potomac, MD and can be reached out via phone at 703-201-0830.

Location: 11702 Gainsborough Rd, Potomac, MD, 20854-3246
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174562540
Provider Name
Shlomo Mark Tanen
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
11702 Gainsborough Rd, Potomac, MD, 20854-3246
Phone Number
703-201-0830
Fax Number
Provider Enumeration Date
06/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0130000215 01 VA BOARD OF MEDICINE LICENSE
00-60-2846-2 05 VA
085814 01 VA ANTHEM
A302-0001 01 VA BCBSNCA
institution
Provider Business Practice Location Address Details
Address
11702 Gainsborough Rd
City
Potomac
State
Maryland
Zip
20854-3246
Phone Number
703-201-0830
Fax Number
person
Provider Business Mailing Address Details
Address
11702 Gainsborough Rd
City
Potomac
State
Maryland
Zip
20854-3246
Phone Number
703-201-0830
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
0130000215 (Virginia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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