Provider Demographics
NPI:1629153283
Name:TANNER, MARC ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ANTHONY
Last Name:TANNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3150 HIGHWAY 153
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9498
Mailing Address - Country:US
Mailing Address - Phone:864-295-1231
Mailing Address - Fax:864-295-0095
Practice Address - Street 1:3150 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-9498
Practice Address - Country:US
Practice Address - Phone:864-295-1231
Practice Address - Fax:864-295-0095
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC33960207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8157Medicare PIN