Tara Ann Cancellaro, MD
Pediatrics, Developmental - Behavioral Pediatrics in Greenville, SC. Individual provider (NPI-1).
NPI number1215969167
StatusActive
Last updated in NPPESMay 23, 2021
Details
- NPI
- 1215969167
- Entity type
- Individual (NPI-1)
- Name
- Tara Ann Cancellaro
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2006
- Certification date
- May 23, 2021
- Last updated
- May 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0006X | Pediatrics, Developmental - Behavioral Pediatrics | 23347 | SC | Yes |
Practice location
29 N Academy StGreenville, SC 29601-2629
Phone 864-331-1300
Mailing address
300 E McBee Ave Fl 4Greenville, SC 29601-2842
Phone 864-522-8617
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