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General NPI Number Information
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NPI Number | 1467737759
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Entity Type | Individual
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Provider Name | GREGORY W TANNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 5899 BREMO RD STE 100
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City | RICHMOND
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State | VA
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Zip | 23226-1935
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Country | US
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Telephone | 804-288-8512
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 715868
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City | PHILADELPHIA
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State | PA
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Zip | 19171-5868
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Country | US
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Telephone | 804-915-1910
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Fax | 804-968-1803
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0101264607
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License Number State | VA
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