Individual
DR. JEFFREY CHRISTIAN FORMOSO TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-9100
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301086199
MI
Other
Enumeration date
05/21/2007
Last updated
12/08/2015
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