MEDICARE: DR. TANYA DAWN MARKIS-MEYER OD

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	152W00000X	Optometrist	10668TPG	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164457891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANYA DAWN MARKIS-MEYER OD

Provider Business Mailing Address
First Line	:	670 SUTTON WAY
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-5392
Country	:	US
Telephone Number	:	530-273-6000
Fax Number	:	530-272-8459

Provider Business Practice Location Address
First Line	:	670 SUTTON WAY
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-5392
Country	:	US
Telephone Number	:	530-273-6000
Fax Number	:	530-272-8459

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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