Individual
BRETT DOUGLAS TANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-4031
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301103442
MI
207P00000X
Emergency Medicine Physician
Primary
61216
MN
390200000X
Student in an Organized Health Care Education/Training Program
4301103442
MI
Other
Enumeration date
06/17/2013
Last updated
09/18/2020
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