Provider Demographics
NPI:1932356565
Name:TAMMI DAVIS, M.D., LLC
Entity Type:Organization
Organization Name:TAMMI DAVIS, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-591-3406
Mailing Address - Street 1:9199 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 203B
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4520
Mailing Address - Country:US
Mailing Address - Phone:410-591-3406
Mailing Address - Fax:410-902-1933
Practice Address - Street 1:9199 REISTERSTOWN RD
Practice Address - Street 2:SUITE 203B
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4520
Practice Address - Country:US
Practice Address - Phone:410-591-3406
Practice Address - Fax:410-902-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty