MIRIAM B. TATUM M.D. – NPI #1770682106
Pediatrics

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

MIRIAM TATUM is a physician located in DERBY LINE, VT. NPPES has assigned the NPI number 1770682106 to MIRIAM TATUM on September 22, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 2080A0000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Adolescent Medicine

The NPI profile was previously updated about 19 years ago on Jul 08, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIRIAM TATUM below.

NPI Profile for
MIRIAM B. TATUM

NPI Number
1770682106
Enumeration Date

(more than 19 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
MIRIAM B. TATUM
Credentials
M.D.
Primary location
159 MAIN STREET
DERBY LINE, VT 05830
Phone: (802) 873-3009 Fax:
Mailing address
PO BOX 970
159 MAIN STREET
DERBY LINE, VT 05830-0970
Phone: (802) 873-3009 Fax:
Sole Proprietor
No
Updated
Identifiers

Identifiers for MIRIAM TATUM

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERSTATE LICENSE NUMBERVT042-0008370
MEDICAIDVT0VN0264
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080A0000X
- Pediatrics / Adolescent Medicine (Primary)
VT 042-0008370

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.