MEDICARE: DR. ANDREW BAMNJO TATAH 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
1	174400000X	Specialist	P3592	TX
2	207P00000X	Emergency Medicine Physician	P3592	TX

General Provider Information

NPI Number	:	1932384377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW BAMNJO TATAH M.D

Provider Business Mailing Address
First Line	:	PO BOX 605012
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43260-5012
Country	:	US
Telephone Number	:	561-203-0611
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 605012
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43260-1992
Country	:	US
Telephone Number	:	561-203-0611
Fax Number	:

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

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	07/24/2025

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Directions to “ DR. ANDREW BAMNJO TATAH M.D” Practice Location

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