| Wilson H Luy Tan, Md Ltd | |
|
705 S University Ave Suite 380 Beaver Dam WI 53916-3053 | |
| (920) 887-3460 | |
| (920) 887-3491 |
| Full Name | Wilson H Luy Tan, Md Ltd |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 705 S University Ave, Beaver Dam, Wisconsin |
| Authorized Official Name and Position | Wilson H Luy Tan (PRESIDENT) |
| Authorized Official Contact | 9208873460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson H Luy Tan, Md Ltd 705 S University Ave Suite 380 Beaver Dam WI 53916-3053 Ph: (920) 887-3460 | Wilson H Luy Tan, Md Ltd 705 S University Ave Suite 380 Beaver Dam WI 53916-3053 Ph: (920) 887-3460 |
| NPI Number | 1134314362 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 09/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134314362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 28716-020 (Wisconsin) | Primary |
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