Individual
NICHOLAS TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-4409
(608) 263-8310
Mailing address
600 HIGHLAND AVE, MADISON, WI 53792-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
REL10028851
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2022
Last updated
06/09/2023
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