Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD.38321 | AL |
N | 2080P0202X | Pediatric Cardiologist | MD.38321 | AL |
NPI | 1275995276 |
---|---|
Provider Name | Christian H Tan |
First Address | Birmingham, AL 35249-0109 |
Second Address | Birmingham, AL 35233-1802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 31/10/2019 |