Provider Demographics
NPI:1841632619
Name:TAN, RONNY BAN WEI (MD)
Entity type:Individual
Prefix:DR
First Name:RONNY
Middle Name:BAN WEI
Last Name:TAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S SARATOGA ST APT 627
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-4826
Mailing Address - Country:US
Mailing Address - Phone:504-615-6542
Mailing Address - Fax:
Practice Address - Street 1:1415 TULANE AVENUE
Practice Address - Street 2:TULANE UNIVERSITY MEDICAL CLINIC (UROLOGY/SUBFERTILITY)
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-615-6542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program