Pat Tana, M.D., PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

D21797 Issued in MD

Legal business name

PAT TANA, M.D., PA

Practice address

5400 Old Court Rd
Suite 101
Randallstown, MD 21133-5100

Phone

(410) 922-1661

Fax

(410) 922-0365

NPI assigned

Aug 6, 2008

Organization subpart

No

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

Authorized official

Name

Pat Tana, M.D., PA

Title

Owner

Phone

(410) 922-1661

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peyapong Patanaphan, M.D., PA Other name

Locations

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231286400000",
    "number": "1992961148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 OLD COURT RD",
            "address_2": "SUITE 101",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335100",
            "telephone_number": "410-922-1661",
            "fax_number": "410-922-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 OLD COURT RD",
            "address_2": "SUITE 101",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335100",
            "telephone_number": "410-922-1661",
            "fax_number": "410-922-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAT TANA, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2009-01-07",
        "status": "A",
        "authorized_official_last_name": "TANA",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-922-1661",
        "authorized_official_credential": "M.D., PA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D21797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "979801300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peyapong Patanaphan, M.D., PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ellison Jinwoo Park, PHARMD
• Deborah Parker
• Donovan Parkes, MD
• Judy Dianne Parks, LCSW-C
• Elvira Pasmanik, M.D.
• Nicholas Patchan, M.D.
• Bhumi Patel
• Bina V Patel
• Yashika Mayur Patel
• Peace & Glory Manor, Inc (Peace & Glory Manor Medical Adult & Senior Plus Daycare Center)

• Specialist in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.