Individual
VIGILIO M TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
219 S SPRING STREET, MARTINSBURG, WV 25401
(304) 267-9981
(304) 267-5884
Mailing address
219 S SPRING STREET, MARTINSBURG, WV 25401
(304) 267-9981
(304) 267-5884
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
13607
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096657000
—
WV
Enumeration date
10/02/2006
Last updated
11/14/2016
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