Provider Demographics
NPI:1477447563
Name:TOLBERT, TUNJA ROSHELL
Entity type:Individual
Prefix:
First Name:TUNJA
Middle Name:ROSHELL
Last Name:TOLBERT
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 EASTDALE RD S APT E
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3642
Mailing Address - Country:US
Mailing Address - Phone:334-207-0061
Mailing Address - Fax:
Practice Address - Street 1:227 EASTDALE RD S APT E
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3642
Practice Address - Country:US
Practice Address - Phone:334-207-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty