Individual
DR. CAROL ANN C TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2769 HEARTLAND DR, SUITE 205, CORALVILLE, IA 52241-2732
(319) 887-2900
(319) 339-3858
Mailing address
PO BOX 2027, IOWA CITY, IA 52244-2027
(319) 339-3855
(319) 358-2791
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036095755
IL
207R00000X
Internal Medicine Physician
Primary
40223
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095755
—
IL
01
—
P00096917
RAILROAD MEDICARE
—
Enumeration date
08/18/2006
Last updated
12/22/2016
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