Individual
NANCY C HAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1919 LAKE AVE STE 104, PLYMOUTH, IN 46563-7830
(574) 948-5170
(574) 948-5498
Mailing address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 335-8707
(574) 335-0741
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01067600A
IN
208600000X
Surgery Physician
40472
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200978740
—
IN
Enumeration date
07/11/2006
Last updated
04/01/2025
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