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Individual

DR. GUBERT LEE TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
222 MARION AVE, MANSFIELD, OH 44903-2138
(419) 526-1964
(419) 526-0012
Mailing address
5400 FRANTZ RD, STE 250, DUBLIN, OH 43016-4144
(614) 544-6155

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
036088453
IL
2084N0400X
Neurology Physician
Primary
35074660
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2072813
OH
Enumeration date
10/03/2005
Last updated
01/25/2022
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