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NPI Code Detail

MEDICARE: STEPHEN TAMANG MD CONSULTING SERVICES PC

MEDICARE: STEPHEN TAMANG MD CONSULTING SERVICES PC
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
1207QA0401XAddiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1073089488
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEPHEN TAMANG MD CONSULTING SERVICES PC
Provider Business Mailing Address
First Line : PO BOX 24154
Second Line :
City : BELFAST
State : ME
Zip : 04915-4492
Country : US
Telephone Number : 605-340-1234
Fax Number : 855-526-0199
Provider Business Practice Location Address
First Line : 625 FLORMANN ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5469
Country : US
Telephone Number : 605-340-1234
Fax Number : 855-526-0199
Authorized Official
Title or Position : SENIOR MANAGER, CREDENTIALING
Name : KATRINA MERRITT
Credential :
Telephone Number : 813-596-5726
Provider Enumeration Date : 10/23/2018
Last Update Date : 11/25/2024

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