MEDICARE: MICHAEL TATRO 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	207P00000X	Emergency Medicine Physician	95624	SC
2	207P00000X	Emergency Medicine Physician	35081291	OH

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	:	1558363143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL TATRO MD

Provider Business Mailing Address
First Line	:	401 MATTHEW ST
Second Line	:
City	:	MARIETTA
State	:	OH
Zip	:	45750-1635
Country	:	US
Telephone Number	:	740-374-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2220 N BELTLINE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-3907
Country	:	US
Telephone Number	:	839-600-9101
Fax Number	:

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	02/19/2026

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