Provider Demographics
NPI:1386638740
Name:PRINGLE, TAMARA R (MD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:R
Last Name:PRINGLE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749112
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9112
Mailing Address - Country:US
Mailing Address - Phone:434-245-1000
Mailing Address - Fax:
Practice Address - Street 1:2955 IVY RD STE 304
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-9353
Practice Address - Country:US
Practice Address - Phone:434-243-4570
Practice Address - Fax:434-295-5491
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238415207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000254222203OtherUNITED
10002838OtherOPTIMA HEALTH
VA010242169Medicaid
410214OtherSOUTHERN HEALTH
60218OtherCARENET
7467784OtherAETNA USHEALTH
1024169OtherVA PREMIER
VAC09633OtherGROUP PTAN
10002838OtherSENTARA
181293OtherANTHEM
2137971OtherMAMSI
1372520OtherCIGNA
541941044002OtherTRICARE
008699S63Medicare PIN
10002838OtherOPTIMA HEALTH