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General NPI Number Information
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NPI Number | 1104020817
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Entity Type | Individual
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Provider Name | TIFFANY S OWENS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 3735 GLENLAKE DR STE 250
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City | CHARLOTTE
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State | NC
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Zip | 28208-6866
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Country | US
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Telephone | 704-749-5800
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Fax | 704-626-3237
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Provider Business Mailing Address
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Address Line | 585 MAIN ST STE 145
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City | LAUREL
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State | MD
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Zip | 20707-4354
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Country | US
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Telephone | 301-298-8267
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Fax | 301-517-9386
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 79988
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2019-02715
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 21797
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME171870
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | V5202
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License Number State | TX
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