NPI 1124002654

Djerrick Cu Tan, MD

Practitioner Diagnostic Radiology Physician Mequon, WI

Practice location

Address: 10945 N Port Washington Rd STE 201, Mequon, WI 53092-5078
Phone: (262) 292-3151

Registered specialties (3)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 47802 (WI)

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Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence MD20361 (RI)

Registry record

NPI: 1124002654
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Nov 2005
Record last updated: 23 Feb 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.