Individual
VINCENT L. KAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 756-9771
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
270097
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110119035A
—
MA
Enumeration date
04/07/2014
Last updated
01/03/2022
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