Provider Demographics
NPI:1508575382
Name:TANZER, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:TANZER
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 1:26 APPLEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H3X 3W6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 CEDAR AVENUE
Practice Address - Street 2:B5.159
Practice Address - City:MONTREAL
Practice Address - State:QUEBEC
Practice Address - Zip Code:H3G 1A4
Practice Address - Country:CA
Practice Address - Phone:514-934-8240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63246207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1850718OtherRAMQ