Provider Demographics
NPI:1184742124
Name:TAN, RAMONA (MD)
Entity type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5602 GULL PRAIRIE WAY
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-3165
Mailing Address - Country:US
Mailing Address - Phone:269-552-9727
Mailing Address - Fax:269-552-9727
Practice Address - Street 1:1722 SHAFFER ST
Practice Address - Street 2:SUITE #3
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1633
Practice Address - Country:US
Practice Address - Phone:269-337-6373
Practice Address - Fax:269-337-6376
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010846372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry