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Individual

DR. STEPHEN MICHAEL TANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1470 MEDICAL PARKWAY, SUITE 160, CARSON CITY, NV 89703-4636
(775) 445-7650
(775) 882-4206
Mailing address
PO BOX 4390, CARSON CITY, NV 89702-4390
(775) 445-7650
(775) 882-4206

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11880
NV
207RI0011X
Interventional Cardiology Physician
11880
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100510311
NV
01
CC4954
BLUE CROSS BLUE SHIELD
Enumeration date
06/20/2006
Last updated
09/18/2014
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