Jaime F Tan MD PLLC
Organization Active NPI General Practice Physician · Harbor Beach, MI
NPI 1255008587 · NPPES record last updated Aug 25, 2021
Key facts
- NPI
- 1255008587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- JAIME F TAN MD PLLC
- Practice address
- 2235 S Lakeshore Rd
Harbor Beach, MI 48441-8910 - Phone
- (989) 479-2143
- NPI assigned
- Aug 25, 2021
- Organization subpart
- No
Authorized official
- Name
- Jaime F Tan, MD
- Title
- Owner
- Phone
- (989) 479-2143
Practitioners 1
-
Jaime F Tan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211102000533 | MI | Part B Supplier - Clinic/Group Practice | 1456749068 |
Receives reassigned benefits from 1 practitioner Practice locations: Harbor Beach, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
2235 S Lakeshore Rd
Harbor Beach, MI 48441-8910
Mailing address
2235 S Lakeshore Rd
Harbor Beach, MI 48441-8910
Phone (989) 479-2143
Other providers in Harbor Beach, MI
- James F Hirn
- Gabriel Benedict Holdwick
- Elizabeth Ann Howison
- Dexter Idnay
- Jaime F Tan MD PC
- James F Hirn DDS
- James N Molitor DDS PC
- Rachel Lynn Kain
- Jean Laurie Kramer
- Shane Robert Kucharczyk
All providers in Harbor Beach, MI · General Practice Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.