Individual
SHARON TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
41 N MAIN ST, SUITE 300, WEST HARTFORD, CT 06107-1972
(860) 313-0448
(860) 313-1464
Mailing address
41 N MAIN ST, SUITE 300, WEST HARTFORD, CT 06107-1972
(860) 313-0448
(860) 313-1464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039000
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
03900
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001390004
—
CT
01
—
010039000CT02
ANTHEM BLUE SHIELD
TN
01
—
2V5173
HEALTHNET
—
Enumeration date
07/26/2006
Last updated
05/13/2024
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