Individual
DR. WALTER TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 NEW BERN AVE STE 1100, WPP - STRUCTURAL HEART, RALEIGH, NC 27610-1231
(919) 232-5202
(919) 231-6334
Mailing address
3000 NEW BERN AVE STE 1100, WPP - STRUCTURAL HEART, RALEIGH, NC 27610-1231
(919) 232-5202
(919) 231-6334
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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