Provider Demographics
NPI:1043586258
Name:MCDONALD, TANYA JOELLE WILLIAMS (MD)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:JOELLE WILLIAMS
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:JOELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:MEYER 2-147
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-502-2227
Mailing Address - Fax:410-955-0751
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:MEYER 2-147
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-6070
Practice Address - Fax:410-955-0751
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00813742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology