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Individual
STEPHANIE TAN
Active
Individual
STEPHANIE TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-06-9271T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0837182
MEDICARE ID
OH
05
—
2035256
—
OH
01
—
577
SUMMA INSURANCE
OH
01
—
729116
BUCKEYE COMMUNITY HEALTH
OH
Enumeration date
03/07/2006
Last updated
04/24/2013
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