Provider Demographics
NPI:1790860880
Name:TOLNER, DAVID JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:TOLNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:JOHN
Other - Last Name:TOLNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:203 HOSPITAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061
Mailing Address - Country:US
Mailing Address - Phone:410-766-4111
Mailing Address - Fax:410-768-5644
Practice Address - Street 1:203 HOSPITAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-766-4111
Practice Address - Fax:410-768-5644
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24862207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521515639OtherTAX ID
MD429091700Medicaid
MD8548Medicare ID - Type Unspecified
MD429091700Medicaid