Provider Demographics
NPI:1396835930
Name:TAN, CAROLINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:M
Last Name:TAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:297 HERNDON PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4474
Mailing Address - Country:US
Mailing Address - Phone:571-323-3300
Mailing Address - Fax:571-323-3300
Practice Address - Street 1:297 HERNDON PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4474
Practice Address - Country:US
Practice Address - Phone:571-323-3300
Practice Address - Fax:571-323-3300
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA01012307382084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry