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O.t. Tan, M.d., P.c.
Specialist in Boston, Massachusetts
NPI 1114198306

O.t. Tan, M.d., P.c. is a Specialist based in Boston, MA. O.t. Tan, M.d., P.c. practices in Boston, MA. The NPI Number for O.t. Tan, M.d., P.c. is 1114198306 and holds a License No. 51655 (Massachusetts).

The current practice location address for O.t. Tan, M.d., P.c. is 29 Commonwealth Ave, Boston, MA and can be reached out via phone at 617-424-8335.

Location: 29 Commonwealth Ave, Boston, MA, 02116-2349
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1114198306
Provider Name
O.t. Tan, M.d., P.c.
Credential
Provider Entity Type
Organization
Address
29 Commonwealth Ave, Boston, MA, 02116-2349
Phone Number
617-424-8335
Fax Number
Provider Enumeration Date
03/17/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
J04322 01 MA BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
29 Commonwealth Ave
City
Boston
State
Massachusetts
Zip
02116-2349
Phone Number
617-424-8335
Fax Number
person
Provider Business Mailing Address Details
Address
29 Commonwealth Ave
City
Boston
State
Massachusetts
Zip
02116-2349
Phone Number
617-424-8335
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
51655 (Massachusetts)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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