| NPI | 1013184159 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ALICE PATRICIA TANNER Pediatrician/Practice Owner 410-768-2231  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine | 
| Enumeration Date | 2008-05-08 | 
| Last Update Date | 2008-05-08 |