Provider Demographics
NPI:1629403969
Name:TALLMAN, JOHN H (NP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:TALLMAN
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DR
Practice Address - Street 2:1ST FLOOR TAUBMAN CENTER RECP D
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5297
Practice Address - Country:US
Practice Address - Phone:734-936-4210
Practice Address - Fax:734-232-8853
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
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Provider Licenses
StateLicense IDTaxonomies
MI4704260144363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner