Larry B Tankanow, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

4301045330 Issued in MI

Practice address

27472 Schoenherr Rd Ste 100
Warren, MI 48088-6675

Phone

(586) 751-8844

Fax

(586) 751-8596

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1073598827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886675",
            "telephone_number": "586-751-8844",
            "fax_number": "586-751-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886675",
            "telephone_number": "586-751-8844",
            "fax_number": "586-751-8596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30117 Schoenherr Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480886851",
            "country_code": "US",
            "telephone_number": "586-751-8844 x102",
            "fax_number": "586-751-8596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANKANOW",
        "first_name": "LARRY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301045330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4559970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Warren, MI
• Providers in Warren, MI by specialty
• Pulmonary Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.