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Organization
BERMING PAN MD INC
Active
Organization
BERMING PAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHEN-TSU PAN MD (MEDICAL DOCTOR)
(702) 486-4255
Entity
Organization
Contact information
Practice address
306 OHIO ST, WANATAH, IN 46390-0367
(219) 733-2755
(219) 733-2377
Mailing address
PO BOX 367, WANATAH, IN 46390-0367
(219) 733-2755
(219) 733-2755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084157
BCBS
IN
05
—
100163680A
—
IN
Enumeration date
12/06/2007
Last updated
01/07/2019
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