Individual
DR. JEREMIAS C TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 JOSEPH SIEWICK DR STE 308, FAIRFAX, VA 22033
(703) 698-8960
(647) 646-4744
Mailing address
3700 JOSEPH SIEWICK DR STE 308, FAIRFAX, VA 22033-1739
(703) 698-8960
(703) 716-8703
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101239223
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101239223
STATE LICENSE
VA
05
—
1699723213
—
VA
01
—
206263
ANTHEM BCBS
—
01
—
206265
ANTHEM BCBS
—
01
—
302447
ANTHEM BCBS
—
01
—
302474
ANTHEM BCBS
—
01
—
341909
ANTHEM BCBS
—
01
—
346674
ANTHEM BCBS
—
01
—
79160018
CAREFIRST BCBS
—
Enumeration date
05/05/2006
Last updated
03/07/2023
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