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Individual
DR. MILTON TAN FONG
Active
Individual
DR. MILTON TAN FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39331
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39331
STATE LICENSE
MN
Enumeration date
08/29/2006
Last updated
11/17/2011
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