Individual
JOSE MARCELINO J DONATO TANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
96799 TURNER DRIVE, PAGO PAGO, AS 96799
(684) 633-1222
(684) 633-2893
Mailing address
PO BOX LBJ, PAGO PAGO, AS 96799-0010
(684) 633-1222
(684) 633-2893
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4090C
AS
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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