Individual
TANDY CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101011944
MI
208000000X
Pediatrics Physician
Primary
5101011944
MI
Other
Enumeration date
07/21/2006
Last updated
09/11/2025
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