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Individual

DR. JOSEFINA C. TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
106 E BROAD ST, SAVANNAH, GA 31401-2917
(912) 527-1000
Mailing address
106 E BROAD ST, SAVANNAH, GA 31401-2917
(912) 527-1000

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
019193
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10063432
AMERIGROUP
05
469298310A
GA
Enumeration date
12/18/2006
Last updated
10/04/2012
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