Individual
DR. MANUEL PAVIA TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4351 E LOHMAN AVE, STE 301, LAS CRUCES, NM 88011-8259
(575) 532-8900
(575) 532-8910
Mailing address
4351 E LOHMAN AVE, STE 301, LAS CRUCES, NM 88011-8259
(575) 532-8900
(575) 532-8910
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
93164
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F9028
—
NM
Enumeration date
09/05/2007
Last updated
05/07/2008
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