Provider Demographics
NPI:1730276486
Name:ANG, ROBERT TAN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TAN
Last Name:ANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:302 APPLETREE LN
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2408
Mailing Address - Country:US
Mailing Address - Phone:219-464-2138
Mailing Address - Fax:219-464-2138
Practice Address - Street 1:3156 WILLOWCREEK ROAD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368
Practice Address - Country:US
Practice Address - Phone:219-464-2138
Practice Address - Fax:219-464-2138
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2025-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL91107827OtherIL BLUE CROSS
IN388050Medicare PIN
C24979Medicare UPIN