Individual
BETHANY BRAGDON TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6251 E VIRGINIA BEACH BLVD STE 300, NORFOLK, VA 23502-2800
(757) 261-5000
(757) 962-5610
Mailing address
6251 E VIRGINIA BEACH BLVD STE 300, NORFOLK, VA 23502-2800
(757) 261-5000
(757) 962-5610
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101056108
VA
208600000X
Surgery Physician
MD34085
DC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
0101056108
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD34085
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010140897
—
DC
05
—
036433200
—
DC
05
—
1427023217
—
VA
05
—
406906400
—
DC
Enumeration date
02/23/2006
Last updated
07/13/2024
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