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General NPI Number Information
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NPI Number | 1356679138
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Entity Type | Individual
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Provider Name | GREG VICTOR IGOT TAMPUS MD
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Gender | Male
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1300 YORK RD STE 190D
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6016
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Country | US
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Telephone | 443-288-5206
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Fax | 443-288-5205
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Provider Business Mailing Address
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Address Line | 1300 YORK RD STE 190D
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-6016
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Country | US
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Telephone | 443-288-5206
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Fax | 443-288-5205
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0076580
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0076580
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License Number State | MD
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