Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301106847 | MI |
N | 111NI0900X | Internist | 4301106847 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 4301106847 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301106847 | MI |
NPI | 1740579200 |
---|---|
Provider Name | Marty Chun-Yen Tam |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 02/07/2019 |