Individual
BEVAN TANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 E CHICAGO AVE, CHICAGO, IL 60611-4296
(312) 503-8223
Mailing address
4251 RUSSELL BLVD APT A, SAINT LOUIS, MO 63110-3510
(757) 395-7609
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2014018834
MO
Other
Enumeration date
01/22/2009
Last updated
07/22/2014
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