MEDICARE: TAMARA L SHILLING DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0102203059	VA
2	207Q00000X	Family Medicine Physician	OP00002069	WA
3	207Q00000X	Family Medicine Physician	16922	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0207872	OTHER	WA	STATE L&I
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P00354456	OTHER	WA	RAILROAD

General Provider Information

NPI Number	:	1760433205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA L SHILLING DO

Provider Business Mailing Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2598
Country	:	US
Telephone Number	:	603-228-7200
Fax Number	:	603-227-7562

Provider Business Practice Location Address
First Line	:	250 PLEASANT ST.
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2598
Country	:	US
Telephone Number	:	603-228-7200
Fax Number	:	603-227-7562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	06/29/2021

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Directions to “ TAMARA L SHILLING DO” Practice Location

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