Tan, Bethany Bragdon
Tan, Bethany Bragdon is an individual health care provider with primary practice located at 6251 E Virginia Beach Blvd Ste 300 , Norfolk VA 23502-2800. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is her primary health care specialty. Tan, Bethany Bragdon can be contacted via phone (757) 261-5000.Contact Information
Primary practice address
6251 E Virginia Beach Blvd Ste 300
Norfolk VA 23502-2800
Phone: (757) 261-5000
Fax: (757) 962-5610
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD34085 | District of Columbia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101056108 | Virginia |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | MD34085 | District of Columbia |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 0101056108 | Virginia |
Profile Details
| NPI number | 1427023217 |
|---|---|
| LBN Legal business name | Tan, Bethany Bragdon |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2006 |
| Last updated | Jul 13th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427023217 | NPPES |
| Virginia | MEDICAID | 1427023217 | |
| Virginia | MEDICAID | 406906400 | |
| Virginia | MEDICAID | 010140897 | |
| Virginia | MEDICAID | 036433200 |
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