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Individual

PETER CHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1600 SW 119TH ST, OKLAHOMA CITY, OK 73170-4908
(405) 425-8100
(405) 425-8109
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 425-8100
(405) 425-8109

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2354
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10048020B
OK
Enumeration date
06/08/2006
Last updated
11/08/2019
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