Provider Demographics
NPI:1841950961
Name:TRUE, TATUM
Entity type:Individual
Prefix:
First Name:TATUM
Middle Name:
Last Name:TRUE
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:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:MAUGANSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21767-0248
Mailing Address - Country:US
Mailing Address - Phone:301-491-6304
Mailing Address - Fax:
Practice Address - Street 1:13815 MAUGANSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:MAUGANSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21767
Practice Address - Country:US
Practice Address - Phone:240-609-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy