Individual
RICHARD T.C. WAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 W ROBERTS ST, MORGANTOWN, KY 42261-7942
(270) 526-3841
(270) 526-2651
Mailing address
101 W ROBERTS ST, MORGANTOWN, KY 42261-7942
(270) 526-3841
(270) 526-2651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16599
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64165996
—
KY
Enumeration date
09/20/2006
Last updated
06/17/2013
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