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NPI Code Detail

MEDICARE: ANNIE R TAN M..D.

MEDICARE:   ANNIE R TAN  M..D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35.091239OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134126683
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNIE R TAN M..D.
Provider Business Mailing Address
First Line : 33100 CLEVELAND CLINIC BLVD
Second Line :
City : AVON
State : OH
Zip : 44011-1390
Country : US
Telephone Number : 440-695-4000
Fax Number :
Provider Business Practice Location Address
First Line : 33100 CLEVELAND CLINIC BLVD
Second Line :
City : AVON
State : OH
Zip : 44011-1390
Country : US
Telephone Number : 440-695-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 02/05/2018

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Directions to “ ANNIE R TAN M..D.” Practice Location

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