MARISSA LUAN TAN


Address: 615 N Wolfe St, Baltimore, MD 21205-2103
Phone: 4109553543

MARISSA LUAN TAN (NPI# 1720583818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720583818
Entity Type Individual
Full Name MARISSA LUAN TAN
Credential DO, MPH
Practice Address 615 N Wolfe St
Baltimore
MD 21205-2103
Practice Telephone 4109553543
Mailing Telephone 4109553543
Mailing Fax Number 6075476612
Enumeration Date 2018-03-29
Last Update Date 2019-09-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208D00000X General Practice H0087983 MD Allopathic & Osteopathic Physicians
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
1 Atwell Rd, Cooperstown, NY 133261301 6075473456 6075476612

Other Providers MARISSA TAN

NPI Name Taxonomy Address Enumeration
1851836472 Marissa Alysha Tan Nurse Anesthetist, Certified Registered 3138 Chimney Ct, Union City, CA 94587-1650 2017-01-05

Office Location

Street Address 615 N WOLFE ST
City BALTIMORE
State MD
Zip Code 21205-2103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639239973 Gregory Dale Kirk Internal Medicine 615 N Wolfe St, Baltimore, MD 21205-2103 2006-12-09
1528690864 Alia Sunderji Pediatrics 615 N Wolfe St, Baltimore, MD 21205-2103 2020-02-05
1497047815 Aurel Ovidiu Iuga Student in an Organized Health Care Education/Training Program 615 N Wolfe St, Baltimore, MD 21205-2103 2011-05-03
1669708616 Samah Nour Preventive Medicine 615 N Wolfe St, Baltimore, MD 21205-2103 2009-10-27
1326278763 Henry Kalter Preventive Medicine 615 N Wolfe St, Rm. E8132, Baltimore, MD 21205-2103 2009-07-20
1588898712 Kevin D. Burns Family Medicine 615 N Wolfe St, Wb602 - Gpmr Office, Baltimore, MD 21205-2103 2009-05-01
1568603397 Robert William Blum Pediatrics 615 N Wolfe St, Baltimore, MD 21205-2103 2009-03-06
1639327356 Richard Bryan Markham Internal Medicine 615 N Wolfe St, Baltimore, MD 21205-2103 2008-09-06
1043471568 Eldesia Labren Granger General Acute Care Hospital 615 N Wolfe St, Wb602, Baltimore, MD 21205-2103 2008-06-18
1730392028 Alfred Sommer Ophthalmology 615 N Wolfe St, Baltimore, MD 21205-2103 2007-05-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467019034 Meghna Rajaprakash Student in an Organized Health Care Education/Training Program 716 N Broadway, Rm 431, Baltimore, MD 21205 2019-05-20
1871158592 Rachel Samantha Bronheim Student in an Organized Health Care Education/Training Program 610 N Caroline St, 5th Floor, Baltimore, MD 21205 2019-05-08
1700342250 Ruth Leeanna Williams Social Worker 504 N. Caroline Street, Baltimore, MD 21205 2019-02-20
1174017032 Anna Kathryn Chassevent Genetic Counselor, MS 801 N. Broadway, Baltimore, MD 21205 2018-06-14
1588115653 Redeem Healthcare and Medical System Inc Case Management 917 North Caroline Street, Baltimore, MD 21205 2016-10-24
1013334929 Crystal Diane Salcido Psychiatry & Neurology 855 N Wolfe St Ste 300, Baltimore, MD 21205 2014-03-28
1487088464 Laura Mitchell Nurse Practitioner 707 N. Broadway Ave, Baltimore, MD 21205 2013-08-27
1477992410 Ferbet Take Care Health Maryland, P.C. Nurse Practitioner 900 N. Washington Street, Baltimore, MD 21205 2013-06-24
1225370570 Amena Smith Fine Pediatrics Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205 2013-03-25
1356695993 Kalpana Prasad Student in an Organized Health Care Education/Training Program 800 North Wolfe St., John G. Rangos, Sr. Building, Room 248, 2nd Floor, Baltimore, MD 21205 2012-11-05
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Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497355879 Cristina Diana Ghinda Student in an Organized Health Care Education/Training Program 600 N Wolfe St Bldg 8, Baltimore, MD 21287-0005 2020-10-27
1265043160 Kathryn Ann Ritchie Student in an Organized Health Care Education/Training Program 1750 E Fairmount Ave Dept Of, Baltimore, MD 21231-1534 2020-08-13
1053929372 Rod Guerrero Salgado Student in an Organized Health Care Education/Training Program 140 N Luzerne Ave, Baltimore, MD 21224-1147 2020-07-22
1518585470 Meshref Ayed Alshehri Student in an Organized Health Care Education/Training Program 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 2020-07-08
1174140503 Thomas Dimitrios Zaikos Student in an Organized Health Care Education/Training Program Pathology Building Rm. 401, 600 N. Wolfe Street, Baltimore, MD 21287 2020-07-01
1649897158 Michael William Mikula Student in an Organized Health Care Education/Training Program Pathology Bldg., Rm. 401, 600 N Wolfe St, Baltimore, MD 21287-0005 2020-06-30
1154948743 Kamilah S Brown Student in an Organized Health Care Education/Training Program 437 E Lorraine Ave, Baltimore, MD 21218-4713 2020-06-29
1306462411 Michael Julian Wong Student in an Organized Health Care Education/Training Program University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 2020-06-24
1467077479 Nashedra Barry Student in an Organized Health Care Education/Training Program 301 N Charles St Apt M1, Baltimore, MD 21201-4397 2020-06-15
1205451804 Ryan Robert Keoni Ingle Student in an Organized Health Care Education/Training Program 29 S Greene St Ste 400, Baltimore, MD 21201-1504 2020-06-10
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Competitor

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City BALTIMORE
Zip Code 21205

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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