Healthcare Provider Details

I. General information

NPI: 1467518266
Provider Name (Legal Business Name): MARCUS CHUAN BENG TAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-1405
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3000
  • Fax:
Mailing address:
  • Phone: 615-936-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD0000056704
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2003013816
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number32623
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number32623
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD0000056704
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: