Healthcare Provider Details

I. General information

NPI: 1003747684
Provider Name (Legal Business Name): TALLMAN MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 WESTFIELD DR
PRINCE FREDERICK MD
20678-3837
US

IV. Provider business mailing address

1080 WESTFIELD DR
PRINCE FREDERICK MD
20678-3837
US

V. Phone/Fax

Practice location:
  • Phone: 443-699-5925
  • Fax:
Mailing address:
  • Phone: 443-699-5925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR TALLMAN
Title or Position: FNP-C/OWNER
Credential: TALLMAN
Phone: 443-835-0689