Provider Demographics
NPI:1750680021
Name:MAPP, TIFFANY ALTAMARIA (DO)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ALTAMARIA
Last Name:MAPP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6005 LANDOVER RD STE 5
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1145
Mailing Address - Country:US
Mailing Address - Phone:240-687-8690
Mailing Address - Fax:443-740-9236
Practice Address - Street 1:6005 LANDOVER RD STE 5
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1145
Practice Address - Country:US
Practice Address - Phone:240-687-8690
Practice Address - Fax:443-740-9236
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH782302207Q00000X
PAOS017242207Q00000X
MDH7832302207VX0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty