MEDICARE: DR. DENNY C. TATE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	29427	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81652	OTHER	NC	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	9908	OTHER	NC	PARTNERS

General Provider Information

NPI Number	:	1033180823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNY C. TATE MD

Provider Business Mailing Address
First Line	:	316 1/2 S. MAIN ST.
Second Line	:
City	:	GRAHAM
State	:	NC
Zip	:	27253-3320
Country	:	US
Telephone Number	:	336-584-9366
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 1/2 S MAIN ST
Second Line	:
City	:	GRAHAM
State	:	NC
Zip	:	27253-3320
Country	:	US
Telephone Number	:	336-228-9759
Fax Number	:	336-227-2794

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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