Individual
DR. XIAO TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
55 FRUIT STREET, BLAKE 4, BOSTON, MA 02114
(617) 643-6361
(617) 724-6832
Mailing address
55 FRUIT STREET, BLAKE 4, BOSTON, MA 02114
(617) 724-6006
(617) 724-6832
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
268832
MA
Other
Enumeration date
06/16/2011
Last updated
05/15/2019
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