Provider Demographics
NPI:1134276926
Name:TATSAS, ARMANDA D (MD)
Entity type:Individual
Prefix:
First Name:ARMANDA
Middle Name:D
Last Name:TATSAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 WESTCORP BLVD SW STE 107
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-6436
Mailing Address - Country:US
Mailing Address - Phone:256-551-1480
Mailing Address - Fax:
Practice Address - Street 1:2904 WESTCORP BLVD SW STE 108
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-6436
Practice Address - Country:US
Practice Address - Phone:256-533-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL39383207ZP0102X
MDD71732207ZC0500X, 207ZP0102X
LAMD.205918207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2330209Medicaid
MD221942YWBMedicare PIN
LA289816YRKCMedicare PIN