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General NPI Number Information
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NPI Number | 1336158518
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Entity Type | Individual
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Provider Name | TAI H TRAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 85 HERRICK ST
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City | BEVERLY
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State | MA
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Zip | 01915-1790
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Country | US
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Telephone | 508-922-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BARTLETT ST
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City | MARBLEHEAD
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State | MA
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Zip | 01945-2720
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Country | US
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Telephone | 781-631-2906
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 73291
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License Number State | MA
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