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NPI Code Detail

MEDICARE: RONNIE G TAN MD

MEDICARE: RONNIE G TAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician35068116OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306888375
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONNIE G TAN MD
Provider Business Mailing Address
First Line : 935 ROUTE 28
Second Line :
City : MILFORD
State : OH
Zip : 45150
Country : US
Telephone Number : 513-831-5955
Fax Number :
Provider Business Practice Location Address
First Line : 935 STATE ROUTE 28
Second Line :
City : MILFORD
State : OH
Zip : 45150-1957
Country : US
Telephone Number : 513-831-5955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 04/13/2015

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Directions to “ RONNIE G TAN MD” Practice Location

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