Provider Demographics
NPI:1265498851
Name:TAN, DEBBIE-ANN L (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE-ANN
Middle Name:L
Last Name:TAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 PLEASANT ST
Mailing Address - Street 2:PRIMA CARE, PC
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-676-3292
Mailing Address - Fax:
Practice Address - Street 1:277 PLEASANT ST
Practice Address - Street 2:PRIMA CARE, PC
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81849207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0016214OtherNEIGHBORHOOD HEALTHPLAN
MA110219104OtherRAILROAD MEDICARE
MA000000021252OtherBMC HEALTHNET
MA3144097Medicaid
MA3684747OtherHEALTHSOURCE
RI204804OtherBLUE CHIP
MA521354OtherAETNA
MA65030OtherHARVARD PILGRIM
MA081849OtherTUFTS HEALTH PLAN
MAB10491501OtherCIGNA
RI0000029261OtherBLUE SHIELD
MAJ16300OtherBLUE SHIELD
MA0403475OtherUNITED HEALTHCARE
MAJ16300OtherBLUE SHIELD
MA521354OtherAETNA