Provider Demographics
NPI:1376834390
Name:ANDERSON, APRIL TANTILLO (MD)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:TANTILLO
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:MARIE
Other - Last Name:TANTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:ONE WYOMING ST
Mailing Address - Street 2:MIAMI VALLEY HOSPITAL
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-208-3356
Mailing Address - Fax:937-208-6033
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:MIAMI VALLEY HOSPITAL
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-3356
Practice Address - Fax:937-208-6033
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125836207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine