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General NPI Number Information
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NPI Number | 1811287634
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Entity Type | Individual
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Provider Name | STEVEN ROBERT TANDBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 25875 SCIENCE PARK DR # AC116
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City | BEACHWOOD
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State | OH
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Zip | 44122-7304
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Country | US
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Telephone | 505-272-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 25875 SCIENCE PARK DR # AC116
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City | BEACHWOOD
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State | OH
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Zip | 44122-7304
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2224-C
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License Number State | AS
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD2013-0597
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License Number State | NM
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