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General NPI Number Information
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NPI Number | 1992589212
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Entity Type | Individual
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Provider Name | CHERN YANG HARMONY TAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 225 ABRAHAM FLEXNER WAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-1882
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Country | US
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Telephone | 502-561-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 LINDSAY AVE APT T1
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City | LOUISVILLE
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State | KY
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Zip | 40206-2258
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Country | US
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Telephone | 502-936-0738
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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 | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 73000267A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | FT663
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License Number State | KY
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