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General NPI Number Information
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NPI Number | 1013466721
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Entity Type | Organization
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Legal Business Name | MULTI-STATE PARTNERSHIP FOR PREVENTION
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 312 WILLOW OAK CIR
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City | PIKESVILLE
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State | MD
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Zip | 21208-6366
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Country | US
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Telephone | 443-570-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 312 WILLOW OAK CIR
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City | PIKESVILLE
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State | MD
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Zip | 21208-6366
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Country | US
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Telephone | 443-570-4858
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TIFFANY TATE
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Credential |
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Telephone | 443-570-4858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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