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Individual

DR. RAYMUNDO T TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
419 5TH ST NE, JAMESTOWN, ND 58401-3300
(701) 252-1050
(701) 952-3265
Mailing address
419 5TH ST NE, JAMESTOWN, ND 58401-3300
(701) 252-1050
(701) 952-3265

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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