Individual
DR. MICHAEL TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1617 N JAMES ST, SUITE 900, ROME, NY 13440-2848
(315) 337-2903
(315) 337-6253
Mailing address
1617 N JAMES ST, SUITE 900, ROME, NY 13440-2848
(315) 337-2903
(315) 337-6253
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1378671
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00582027
—
NY
01
—
1040426013829
FIDELLS CARE NY
NY
01
—
111530400
US DEPT OF LABOR
NY
01
—
185034
MVP HEALTH CARE
NY
Enumeration date
02/08/2006
Last updated
06/30/2008
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