Provider Demographics
NPI:1760651210
Name:LEMEN, TIFFANI DAWN (MD)
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:DAWN
Last Name:LEMEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36825 GROVE ESTATE RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-2757
Mailing Address - Country:US
Mailing Address - Phone:304-546-7595
Mailing Address - Fax:
Practice Address - Street 1:36825 GROVE ESTATE RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-2757
Practice Address - Country:US
Practice Address - Phone:304-546-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD24139207Q00000X
SC84912207Q00000X
IN01084616A207Q00000X
KY54279207Q00000X
MA285704207Q00000X
ALMD.41530207Q00000X
CT66797207Q00000X
FL146700207Q00000X
GA86957207Q00000X
MDD0090176207Q00000X
NC2020-04043207Q00000X
PAMD438574207Q00000X
MI4301502913207Q00000X
MS28198207Q00000X
DEC1-0023955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024717770001Medicaid
PA1024717770001Medicaid