Provider Demographics
NPI:1841480977
Name:PINNEY, TANNER A (MD)
Entity type:Individual
Prefix:DR
First Name:TANNER
Middle Name:A
Last Name:PINNEY
Suffix:
Gender:M
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 2307
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49422-2307
Mailing Address - Country:US
Mailing Address - Phone:616-399-4946
Mailing Address - Fax:616-399-7229
Practice Address - Street 1:602 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4918
Practice Address - Country:US
Practice Address - Phone:616-392-5141
Practice Address - Fax:616-399-7229
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI51562-020207L00000X
MI4301095799207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology