Provider Demographics
NPI:1255305132
Name:TAMESIS, ERIC R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:TAMESIS
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 1:111 WOLF CREEK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4969
Mailing Address - Country:US
Mailing Address - Phone:302-744-9690
Mailing Address - Fax:302-744-9046
Practice Address - Street 1:111 WOLF CREEK BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4969
Practice Address - Country:US
Practice Address - Phone:302-744-9690
Practice Address - Fax:302-744-9046
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT130733207RR0500X
DEC10005967207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032347Medicaid
DE1000032347Medicaid
DEG01518T01Medicare PIN