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NPI Code Detail

MEDICARE: DR. PATRICIA REED TATE M.D.

MEDICARE: DR. PATRICIA REED TATE M.D.
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
1207N00000XDermatology Physician01025438AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
9241950OTHERINUNICARE MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000062193OTHERINANTHEM BENEFIT
2000000062193OTHERINONE NATION BENEFIT
3000000062193OTHERININDIANA HEALTH
4000000062193OTHERINANTHEM SENIOR ADVANTAGE
5000000062193OTHERINANTHEM
6000000062193OTHERKYANTHEM
7000000062193OTHERINUNICARE
8000000062193OTHERININDIANA COMPREHENSIVE

General Provider Information

NPI Number : 1518959998
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA REED TATE M.D.
Provider Business Mailing Address
First Line : PO BOX 950165
Second Line : DEPT 53069
City : LOUISVILLE
State : KY
Zip : 40295-0165
Country : US
Telephone Number : 812-945-3916
Fax Number : 812-944-3404
Provider Business Practice Location Address
First Line : 911 N SHELBY ST
Second Line :
City : SALEM
State : IN
Zip : 47167-2304
Country : US
Telephone Number : 812-883-5881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 02/20/2008

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Directions to “ DR. PATRICIA REED TATE M.D.” Practice Location

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