MARK P. TANENBAUM (NPI# 1114929247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114929247 |
| Entity Type | Individual |
| Full Name | MARK P. TANENBAUM |
| Credential | M.D. |
| Practice Address |
4660 Kenmore Ave Ste 1200 Alexandria VA 22304-1311 |
| Mailing Address |
2901 Telestar Ct. #300 Falls Church VA 22042-1263 |
| Practice Telephone | 7037518111 |
| Practice Fax Number | 7037511105 |
| Mailing Telephone | 7035911688 |
| Mailing Fax Number | 7035911445 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2020-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
0101043105 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | RAILROAD MEDICARE DC # | 060035106 | 01 |
| VA | 1114929247 | 05 | |
| DC | 031738500 | 05 | |
| VA | RAILROAD MEDICARE VA # | 060062627 | 01 |
| MD | 121300800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3580 Joseph Siewick Dr Ste 305, Fairfax, VA 220331764 | 7036483266 | 7036483264 |
| 4660 Kenmore Ave Ste 1200, Alexandria, VA 223041311 | 7037518111 | 7037511105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093817298 | Mark Harris Tanenbaum | Dermatology | 760 Brookhaven Circle, Memphis, TN 38117 | 2006-09-01 |
| 1689656399 | Mark Tanenbaum | Podiatrist | 1648 E 14th St, Brooklyn, NY 11229-1175 | 2005-11-17 |
| Street Address |
4660 KENMORE AVE STE 1200 |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22304-1311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770970097 | Elizabeth S. Dunning | Nurse Practitioner | 4660 Kenmore Ave Ste 1200, Alexandria, VA 22304-1311 | 2015-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489768 | Anthony Michael Frato | Counselor | 205 S Whiting St #601, Alexandria, VA 22304 | 2020-02-14 |
| 1245885805 | Personal Touch Personal Care Providers, LLC | In Home Supportive Care | 4241-d8 Duke Street, Alexandria, VA 22304 | 2019-08-09 |
| 1336658772 | Jade F. Hillery | Doula | 5240 Duke St #310, Alexandria, VA 22304 | 2017-09-28 |
| 1447784731 | Aymara Matos | Behavioral Analyst | 5426 Richenbacher Ave Apt 100, Alexandria, VA 22304 | 2017-04-13 |
| 1659827871 | Tesfaye A Hailemariam Dds PC | Dentist | 5764 Dow Ave, Alexandria, VA 22304 | 2016-08-28 |
| 1912302605 | Alexandria Health Department | Clinic/Center | 1200 North Howard, Alexandria, VA 22304 | 2014-10-24 |
| 1497157663 | Aminata Jalloh | Registered Nurse | 101 South Whiting St, Alexandria, VA 22304 | 2014-09-19 |
| 1386075133 | Carla Renee Riley | Registered Nurse | 4320 Raleigh Ave, Apt 204, Alexandria, VA 22304 | 2013-12-04 |
| 1700223500 | Landmark Dental Care | Dentist | 101 S. Whiting St., Suite 100, Alexandria, VA 22304 | 2013-06-03 |
| 1114266954 | Stella M Meusch | Physician Assistant | 4230 Seminary Rd, Alexandria, VA 22304 | 2013-02-13 |
| Find all providers in zip 22304 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482102 | Careclix Inc | Internal Medicine | 206 N Washington St Ste 100, Alexandria, VA 22314-2534 | 2020-03-14 |
| 1376711325 | Shaila Garg | Internal Medicine | 6651 Kelsey Point Cir, Alexandria, VA 22315-5529 | 2008-02-12 |
| 1679759658 | Red River Cardiology, LLC | Internal Medicine | 201 4th St Ste 4a, Box 30106, Alexandria, LA 71301-8421 | 2008-01-21 |
| 1336330992 | Alfred C Myaing Md Pa | Internal Medicine | 2863 Duke St, Alexandria, VA 22314-4512 | 2007-08-07 |
| 1215905724 | Matthew Adam Lucks | Internal Medicine | 700 S Washington St Ste 330, Alexandria, VA 22314 | 2006-03-09 |
| 1164404505 | Alfred Chit Myaing | Internal Medicine | 2863 Duke Street, Alexandria, VA 22314 | 2005-11-18 |
| 1851397467 | Stephen M. Day | Internal Medicine | 4660 Kenmore Ave., Ste 1200, Alexandria, VA 22304-1311 | 2005-06-28 |
| 1841292091 | Lawrence R. Rubin | Internal Medicine | 4660 Kenmore Ave, Ste 1200, Alexandria, VA 22304-1311 | 2005-06-01 |
| 1417371899 | Harry Hawthorne M.d. A Professional Medical Corporation | Internal Medicine | 2108 Texas Ave, Suite 3062, Alexandria, LA 71301-3944 | 2014-02-06 |
| 1891938775 | The Cardiovascular Group, PC | Internal Medicine | 4660 Kenmore Ave, #1200, Alexandria, VA 22304-1313 | 2009-04-08 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 22304 |
Please comment or provide details below to improve the information on MARK P. TANENBAUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.