Provider Demographics
NPI:1093805350
Name:WARKENTIEN, TYLER ERNEST (MD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:ERNEST
Last Name:WARKENTIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 GUNSTON DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-9312
Mailing Address - Country:US
Mailing Address - Phone:757-923-0363
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL AMERICANO
Practice Address - Street 2:BASE NAVAL DE ROTA APARTADO DE CORREOS 33
Practice Address - City:ROTA
Practice Address - State:CADIZ
Practice Address - Zip Code:11530
Practice Address - Country:ES
Practice Address - Phone:727-727-3504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine