Individual
DR. MICHAEL C TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3701 12TH ST N STE 202, SAINT CLOUD, MN 56303-2253
(320) 258-3090
(320) 258-3095
Mailing address
3701 12TH ST N STE 202, SAINT CLOUD, MN 56303-2253
(320) 258-3090
(320) 258-3095
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
57414-20
WI
207L00000X
Anesthesiology Physician
Primary
60120
MN
207R00000X
Internal Medicine Physician
0101249917
VA
207R00000X
Internal Medicine Physician
018923
ME
207R00000X
Internal Medicine Physician
15555
NH
207R00000X
Internal Medicine Physician
57414-20
WI
Other
Enumeration date
04/21/2011
Last updated
01/09/2016
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