Tan, Stephen R
Tan, Stephen R is an individual health care provider with primary practice located at 401 Phalen Blvd , Saint Paul MN 55130-5302. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Tan, Stephen R can be contacted via phone (651) 254-7580.Contact Information
Primary practice address
401 Phalen Blvd
Saint Paul MN 55130-5302
Phone: (651) 254-7580
Fax: (651) 254-7584
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 44614 | Minnesota |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 44614 | Minnesota |
Profile Details
| NPI number | 1669446415 |
|---|---|
| LBN Legal business name | Tan, Stephen R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 2006 |
| Last updated | Aug 14th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669446415 | NPPES |
| Minnesota | MEDICAID | 064221500 |
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