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General NPI Number Information
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NPI Number | 1821005059
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Entity Type | Organization
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Legal Business Name | PAUL A TARANTINO, M.D.,P.A.
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 1403 MADISON PARK DR SUITE 100
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City | GLEN BURNIE
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State | MD
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Zip | 21061-5613
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Country | US
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Telephone | 410-590-9260
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Fax | 410-590-9266
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Provider Business Mailing Address
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Address Line | 806 LANDMARK DR SUITE 400
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4980
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Country | US
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Telephone | 410-590-9260
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Fax | 410-590-9266
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL ANGELO TARANTINO
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Credential | M.D.
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Telephone | 410-590-9260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D43467
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License Number State | MD
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