Individual
DR. MILTON TAN FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7373 FRANCE AVE S, SUITE 202, EDINA, MN 55435-4534
(952) 428-0200
(952) 428-0096
Mailing address
7373 FRANCE AVE S, SUITE 202, EDINA, MN 55435-4534
(952) 428-0200
(952) 428-0096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39331
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39331
STATE LICENSE
MN
Enumeration date
08/29/2006
Last updated
11/17/2011
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