Individual
TED FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20010 CENTURY BLVD STE 200, GERMANTOWN, MD 20874-1118
(240) 686-2300
Mailing address
2101 E JEFFERSON ST, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101262616
VA
207P00000X
Emergency Medicine Physician
MD045152
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2013
Last updated
07/21/2022
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