Individual
DOMINGO C TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
736 BATTLEFIELD BLVD N, CHESAPEAKE, VA 23320-4941
(757) 312-6124
(757) 312-6195
Mailing address
PO BOX 844527, BOSTON, MA 02284-4527
(757) 867-6101
(757) 867-6588
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101023086
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007256850
—
VA
Enumeration date
08/03/2006
Last updated
03/23/2018
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