Healthcare Provider Details

I. General information

NPI: 1447203765
Provider Name (Legal Business Name): DAVID TUNKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

PO BOX 64588
BALTIMORE MD
21264-4588
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-1686
  • Fax:
Mailing address:
  • Phone: 410-955-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberD35923
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: