Nicholas Tannenbaum
Emergency Medical Services
1120 15th St
Augusta
, Georgia 30912-0004
Nicholas Tannenbaum
Emergency Medical Services
1120 15th St
Augusta
, Georgia 30912-0004
(630) 487-0407
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About
Features
Specialties
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Nicholas Tannenbaum
- 1186 George W Crawford Dr
- Augusta, GA
- Zip : 30909-0082
- Phone : (630) 487-0407
Second Address
- Nicholas Tannenbaum
- 1120 15th St
- Augusta, GA
- Zip : 30912-0004
- Phone : (630) 487-0407
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PE0004X | Emergency Medical Services | 12918 | GA |
National Provider Identifier
| NPI | 1013584382 |
|---|---|
| Provider Name | Nicholas Tannenbaum |
| First Address | Augusta, GA 30909-0082 |
| Second Address | Augusta, GA 30912-0004 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2021 |
| Last Update Date | 07/06/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.