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NPI Code Detail

MEDICARE: WEN RUI TAN

MEDICARE: WEN RUI TAN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1508700980
Entity Type Code : Individual
Provider Name (Legal Business Name) : WEN RUI TAN
Provider Business Mailing Address
First Line : 2643 HIGHLAND AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-2301
Country : US
Telephone Number : 513-501-3089
Fax Number :
Provider Business Practice Location Address
First Line : 3333 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-3026
Country : US
Telephone Number : 513-501-3089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2026
Last Update Date : 04/16/2026

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Directions to “ WEN RUI TAN ” Practice Location

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