Individual
GIM H TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
813 N WASHINGTON AVE, ROSWELL, NM 88201-3941
(575) 622-2606
(575) 622-6645
Mailing address
813 N WASHINGTON AVE, ROSWELL, NM 88201-3941
(575) 622-2606
(575) 622-6645
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD2005-0011
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8026564
—
NM
Enumeration date
02/06/2006
Last updated
12/08/2021
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