Provider Demographics
NPI:1912094491
Name:WEST, TINA B (MD)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:B
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 1440
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-986-9411
Mailing Address - Fax:301-986-9460
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 1440
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-986-9411
Practice Address - Fax:301-986-9460
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDD0041594207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology