CHUNG NING TAN

FORT WAYNE, IN
NPI1619357779
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01077240A)
Additional Taxonomies207Q00000X Family Medicine
(Licence: IN  11018187)
Enumeration Date2015-06-04
Last Update Date2022-10-07
Business Address
CHUNG NING TAN MD
7230 ENGLE RD
FORT WAYNE, IN 46804
Phone number: 260-234-5400
Mailing Address
CHUNG NING TAN MD
1200 W WHITE RIVER BLVD PROVIDER ENROLLMENT DEPARTMENT
MUNCIE, IN 47303-4988
Phone number: 260-234-5400
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