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General NPI Number Information
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NPI Number | 1083903819
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Entity Type | Individual
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Provider Name | TAMMY SURPRIN M.AC., L.AC.
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Gender | Female
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 2110 PRIEST BRIDGE DR STE 3
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City | CROFTON
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State | MD
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Zip | 21114-2472
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Country | US
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Telephone | 240-687-7833
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Fax |
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Provider Business Mailing Address
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Address Line | 16322 ELKHORN LN
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City | BOWIE
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State | MD
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Zip | 20716-3267
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Country | US
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Telephone | 240-687-7833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U01883
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License Number State | MD
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