Individual
MR. JAIME F TAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
233 STATE ST, HARBOR BEACH, MI 48441-1206
(989) 479-3111
(989) 479-9880
Mailing address
233 STATE ST, HARBOR BEACH, MI 48441-1206
(989) 479-3111
(989) 479-9880
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
JT042959
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0803200182
BCBS
MI
05
—
1754354
—
MI
Enumeration date
09/16/2005
Last updated
07/08/2007
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