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General NPI Number Information
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NPI Number | 1164441242
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Entity Type | Individual
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Provider Name | HARSHA TANKALA MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 1125 FORREST AVE SUITE 203
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City | DOVER
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State | DE
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Zip | 19904-3483
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Country | US
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Telephone | 302-346-0101
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Fax | 302-346-0103
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Provider Business Mailing Address
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Address Line | 319 QUAILS NEST DR
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City | DOVER
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State | DE
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Zip | 19904-5586
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Country | US
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Telephone | 302-678-0950
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | C1-0005962
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License Number State | DE
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