Provider Demographics
NPI:1558627976
Name:VANDER TUIG, BERENDENA IRENE MONSMA (MD)
Entity Type:Individual
Prefix:DR
First Name:BERENDENA
Middle Name:IRENE MONSMA
Last Name:VANDER TUIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E EAGER ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-5533
Mailing Address - Country:US
Mailing Address - Phone:410-522-9800
Mailing Address - Fax:410-367-2174
Practice Address - Street 1:1000 E EAGER ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-5533
Practice Address - Country:US
Practice Address - Phone:410-522-9800
Practice Address - Fax:410-367-2174
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0081041207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology