Provider Demographics
NPI:1396806808
Name:TANKEH, VICTORIA A (MD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:A
Last Name:TANKEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:1396 PICCARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4302
Practice Address - Country:US
Practice Address - Phone:301-548-5805
Practice Address - Fax:301-548-5805
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD154612084P0800X
VA01010389772084P0800X
MDD327892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E22192Medicare UPIN
013854K92Medicare ID - Type Unspecified