Provider Demographics
NPI:1700355229
Name:MATEER, TANZA
Entity Type:Individual
Prefix:
First Name:TANZA
Middle Name:
Last Name:MATEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROTHERMEL DR
Mailing Address - Street 2:
Mailing Address - City:YEAGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17099-9707
Mailing Address - Country:US
Mailing Address - Phone:717-248-8791
Mailing Address - Fax:
Practice Address - Street 1:25 ROTHERMEL DR
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-9707
Practice Address - Country:US
Practice Address - Phone:717-248-8791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist