Individual
DR. FREDERICK S TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
K8511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017GC
BLUE CROSS BLUE SHILED
—
01
—
390007453
RAILROAD MEDICARE
—
Enumeration date
07/26/2006
Last updated
02/02/2012
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