Individual
DR. GLENN ANTHONY TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM INC, BELOIT, WI 53511-1842
(608) 364-2220
(608) 364-2489
Mailing address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM INC, BELOIT, WI 53511-1842
(608) 364-2220
(608) 364-2489
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036-119964
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
50634
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689692410
—
WI
Enumeration date
07/18/2006
Last updated
10/20/2011
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