Individual
DR. CHIEH-MIN FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 CYPRESS ST, BROOKLINE, MA 02445-6002
(857) 307-0896
Mailing address
75 FRANCIS ST, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-4763
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
150623
MA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
150623
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150623
TUFTS HEALTH PLAN
MA
05
—
3154114
—
MA
01
—
J16716
BCBS MA
MA
Enumeration date
02/08/2006
Last updated
06/19/2012
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