# JAIME F TAN MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255008587
- **Authorized official:** JAIME F TAN MD (OWNER)
- **Authorized official phone:** (989) 479-2143

## Contact information

- **Practice address:** 2235 S LAKESHORE RD, HARBOR BEACH, MI 48441-8910
- **Practice address phone:** (989) 479-2143
- **Mailing address:** 2235 S LAKESHORE RD, HARBOR BEACH, MI 48441-8910
- **Mailing address phone:** (989) 479-2143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2021
- **Last updated:** 08/25/2021