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General NPI Number Information
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NPI Number | 1235795659
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Entity Type | Individual
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Provider Name | RICHARD TAN LI ZHE MBBCH
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Gender | Male
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 2104 CHESTNUT ST
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City | MONTGOMERY
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State | AL
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Zip | 36106-1113
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Country | US
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Telephone | 334-801-9952
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Fax |
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Provider Business Mailing Address
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Address Line | 2104 CHESTNUT ST
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City | MONTGOMERY
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State | AL
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Zip | 36106-1113
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Country | US
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Telephone | 334-801-9952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 51108
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License Number State | AL
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