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General NPI Number Information
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NPI Number | 1457890618
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Entity Type | Individual
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Provider Name | TAMBER TOWNSEND
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Gender | Female
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 18211 W 12 MILE RD
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-2641
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Country | US
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Telephone | 248-677-2410
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1073
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City | CLARKSTON
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State | MI
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Zip | 48347-1073
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Country | US
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Telephone | 248-242-3655
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Fax | 248-212-0423
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 4704271854
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License Number State | MI
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