Individual
DR. WALTER TAN
Active
Individual
DR. WALTER TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
200201012
NC
207RI0011X
Interventional Cardiology Physician
Primary
200201012
NC
2085R0204X
Vascular & Interventional Radiology Physician
200201012
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
200201012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131VT
BCBSNC
NC
01
—
190783
MEDCOST
NC
05
—
89131VT
—
NC
01
—
P00418889
MEDICARE RAILROAD
NC
Enumeration date
07/24/2006
Last updated
03/24/2015
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