| Doctor Name: | GREG VICTOR IGOT TAMPUS |
| NPI Number: | 1356679138 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | D0076580 |
| Business Practice Address: | 4155 Glen Park Rd Nottingham, MD - 212361019 |
| Business Phone Number: | 4439300661 |
| Business Fax Number: | 4105264819 |
| Mailing Address: | 212 Oak Valley Dr, BEL AIR |
| State: | MD |
| Postal Code: | 210145941 |
| Phone Number: | 4102480661 |
| Fax Number: | 4102489771 |
| NPI Enumeration Date: | 12/07/2009 |
| NPI Last Update Date: | 10/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | D0076580 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |