Individual
EDMUNDO NOEL TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 279-3567
(812) 275-1344
Mailing address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 279-3567
(812) 275-1344
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01031283A
IN
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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