| Doctor Name: | ULDARICO BADIONGAN TAN |
| NPI Number: | 1033167473 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME34199 |
| Business Practice Address: | 1000 S Main St Chattahoochee, FL - 323242230 |
| Business Phone Number: | 8506637383 |
| Business Fax Number: | |
| Mailing Address: | 1000 S Main St, CHATTAHOOCHEE |
| State: | FL |
| Postal Code: | 323242230 |
| Phone Number: | 8506637383 |
| Fax Number: | |
| NPI Enumeration Date: | 05/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | ME34199 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |