Individual
MICHELLE H TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 S FREDERICK AVE, STE 302, GAITHERSBURG, MD 20877-1245
(301) 208-1188
(301) 208-1188
Mailing address
12224 WONDER VIEW WAY, NORTH POTOMAC, MD 20878-3750
(240) 994-5657
(301) 208-1178
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0060871
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405459800
—
MD
Enumeration date
03/22/2006
Last updated
11/16/2009
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