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Individual

VALIANT D TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 VOLVO PKWY, SUITE 200, CHESAPEAKE, VA 23320-1602
(757) 549-4403
(757) 549-4332
Mailing address
5900 LAKE WRIGHT DR, SUITE 300, NORFOLK, VA 23502-1871
(757) 213-5700
(757) 213-5701

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101058223
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005816157
VA
01
52374
OPTIMA
VA
01
830005078
RAILROAD MEDICARE
VA
01
830005079
RAILROAD MEDICARE
NC
Enumeration date
06/20/2005
Last updated
04/14/2011
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