Individual
DR. RAYMUNDO T TAN
Active
Individual
DR. RAYMUNDO T TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4669
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01008891
PREFERRED ONE
—
01
—
13243
BLUE SHIELD
ND
01
—
16-11656
MEDICA
—
05
—
18514
—
ND
01
—
46031641458401C003
TRICARE
—
01
—
47607
HEALTHPARTNERS
—
01
—
719609
AMERICA'S PPO
—
05
—
7207820
—
SD
Enumeration date
11/29/2005
Last updated
02/06/2008
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