Provider Demographics
NPI:1235795659
Name:TAN LI ZHE, RICHARD (MBBCH)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:TAN LI ZHE
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1113
Mailing Address - Country:US
Mailing Address - Phone:334-801-9952
Mailing Address - Fax:
Practice Address - Street 1:2104 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1113
Practice Address - Country:US
Practice Address - Phone:334-801-9952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2025-05-30
Deactivation Date:2019-12-20
Deactivation Code:
Reactivation Date:2020-01-16
Provider Licenses
StateLicense IDTaxonomies
AL511082086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery