Provider Demographics
NPI:1831388875
Name:TAMERIS, CAROL L (MSPT)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:L
Last Name:TAMERIS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:CAROL
Other - Middle Name:L
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:10020 SOUTHERN MARYLAND BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3031
Mailing Address - Country:US
Mailing Address - Phone:301-855-6326
Mailing Address - Fax:301-855-6328
Practice Address - Street 1:10020 SOUTHERN MARYLAND BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3031
Practice Address - Country:US
Practice Address - Phone:301-855-6326
Practice Address - Fax:301-855-6328
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD190N193GMedicare PIN