Individual provider · Type 1 NPI

Vanessa Tan, DO, MBA

Student in an Organized Health Care Education/Training Program · St. Clair Shores, MI

NPI number 1003603416 Active

Practice location

24911 Little Mack Ave Ste C
St. Clair Shores, MI 48080-3200

Call (586) 777-2050 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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.

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About NPI 1003603416

Vanessa Tan, DO, MBA's National Provider Identifier is 1003603416, issued on Apr 21, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in St. Clair Shores, MI. The record was last updated on Aug 20, 2025.