Provider Demographics
NPI:1619741105
Name:STEPHEN TAMANG MD CONSULTING SERVICES PC
Entity Type:Organization
Organization Name:STEPHEN TAMANG MD CONSULTING SERVICES PC
Other - Org Name:PROJECT RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR MANAGER, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-596-5726
Mailing Address - Street 1:625 FLORMANN ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5469
Mailing Address - Country:US
Mailing Address - Phone:605-467-8030
Mailing Address - Fax:
Practice Address - Street 1:625 FLORMANN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5469
Practice Address - Country:US
Practice Address - Phone:605-467-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHEN TAMANG MD CONSULTING SERVICES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-14
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty