Provider Demographics
NPI:1700142296
Name:ALBIN, TANNA D (MD)
Entity Type:Individual
Prefix:DR
First Name:TANNA
Middle Name:D
Last Name:ALBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2030 CHURCHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107-1044
Mailing Address - Country:US
Mailing Address - Phone:317-786-9285
Mailing Address - Fax:317-781-2793
Practice Address - Street 1:2030 CHURCHMAN AVE
Practice Address - Street 2:
Practice Address - City:BEECH GROVE
Practice Address - State:IN
Practice Address - Zip Code:46107-1044
Practice Address - Country:US
Practice Address - Phone:317-786-9285
Practice Address - Fax:317-781-2793
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01075666A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine