National Provider Identifier Database

MATT TANNENBAUM, MD – NPI #1093783375
Anatomic Pathology & Clinical Pathology

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.


Contact Information

MATT TANNENBAUM, MD
3100 CHANNING WAY
IDAHO FALLS, ID83404-7533
Phone: 208-529-6050
Fax: 208-529-7085
Website:
Specialty Taxonomy Code
* Anatomic Pathology & Clinical Pathology 207ZP0102X

* Indicates primary specialty

NPI Profile & details for MATT TANNENBAUM

NPI Number 1093783375
Credentials MD
Entity Individual
Enumeration date 03/10/2006
Last updated 12/27/2012 - About 13 years ago
Sole proprietor1 No
Identifiers
  • ID License #: M7775
  • ID Medicaid: 805449000
  • ID Other: 32946 BLUE CROSS OF ID
  • ID Other: 000010005388 REGENCE BLUE SHIELD ID
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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