| Michael Tanner, Md Pllc | |
|
8170 W Sahara Ave Ste 202 Las Vegas NV 89117-1981 | |
| (702) 686-3762 | |
| (913) 871-9266 |
| Full Name | Michael Tanner, Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8170 W Sahara Ave Ste 202, Las Vegas, Nevada |
| Authorized Official Name and Position | Cliff Brown (ADMINISTRATOR) |
| Authorized Official Contact | 7026863762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Tanner, Md Pllc 8170 W Sahara Ave Ste 202 Las Vegas NV 89117-1981 Ph: (702) 686-3762 | Michael Tanner, Md Pllc 8170 W Sahara Ave Ste 202 Las Vegas NV 89117-1981 Ph: (702) 686-3762 |
| NPI Number | 1134671902 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 08/17/2020 |
| Certification Date | 08/17/2020 |
| Medicare PECOS PAC ID | 6204190051 |
|---|---|
| Medicare Enrollment ID | O20180503001307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134671902 | NPI | - | NPPES |
| Provider Name | Michael S Tanner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083903249 PECOS PAC ID: 8820217805 Enrollment ID: I20160810000401 |
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