Individual
MARY LAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-4049
Mailing address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30290
NE
208D00000X
General Practice Physician
30290
NE
Other
Enumeration date
06/29/2016
Last updated
08/21/2019
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