Individual
TOM XIAOLIN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
Mailing address
PO BOX 5128, LIMA, OH 45802-5128
(419) 224-5707
(419) 229-0040
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.069960
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000177814
ANTHEM BCBS
OH
05
—
2193791
—
OH
01
—
300111996
RAILROAD MEDICARE
OH
01
—
300117618
RAILROAD MEDICARE
OH
Enumeration date
03/28/2006
Last updated
07/25/2013
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