Healthcare Provider Details

I. General information

NPI: 1134052145
Provider Name (Legal Business Name): TONY CHRISTOPHER TATUM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 55TH ST NE
WASHINGTON DC
20019-6784
US

IV. Provider business mailing address

5104 A ST SE
WASHINGTON DC
20019-6431
US

V. Phone/Fax

Practice location:
  • Phone: 202-572-5226
  • Fax:
Mailing address:
  • Phone: 202-579-5226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: