Cancellaro, Tara Ann

Cancellaro, Tara Ann is an individual health care provider with primary practice located at 29 N Academy St , Greenville SC 29601-2629. She recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as her primary health care specialty. Cancellaro, Tara Ann can be contacted via phone (864) 331-1300.

Contact Information

Primary practice address
29 N Academy St Greenville SC 29601-2629
Phone: (864) 331-1300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X 23347 South Carolina

Profile Details

NPI number 1215969167
LBN Legal business name Cancellaro, Tara Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated May 23rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215969167 NPPES
South Carolina MEDICAID T75335

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