Individual
ROBERT S FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 STATE STREET, SALEM, OR 97301
(503) 540-6300
Mailing address
1600 STATE STREET, SALEM, OR 97301
(503) 540-6300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G81021
CA
207X00000X
Orthopaedic Surgery Physician
Primary
MD27700
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G810210
—
CA
05
—
274415
—
OR
Enumeration date
05/27/2005
Last updated
01/25/2022
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