Healthcare Provider Details

I. General information

NPI: 1598095788
Provider Name (Legal Business Name): HAO YANG TAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR STE G-10
COLUMBIA MD
21044-3260
US

IV. Provider business mailing address

10710 CHARTER DR STE G-10
COLUMBIA MD
21044-3260
US

V. Phone/Fax

Practice location:
  • Phone: 410-720-8530
  • Fax: 410-720-7263
Mailing address:
  • Phone: 410-720-8530
  • Fax: 410-720-7263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD70095
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: