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Individual

KENNETH L FAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3800 RESERVOIR RD NW, DEPARTMENT OF PLASTIC SURGERY, WASHINGTON, DC 20007
(202) 444-1233
Mailing address
3800 RESERVOIR RD NW, DEPARTMENT OF PLASTIC SURGERY, WASHINGTON, DC 20007-2113
(202) 444-1233

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD045855
DC

Other

Enumeration date
04/02/2012
Last updated
09/06/2018
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