Individual
JACK SUI KI CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 N TOWN CENTER DR UNIT 1033, LAS VEGAS, NV 89144-0577
(517) 899-5453
Mailing address
1350 N TOWN CENTER DR UNIT 1033, LAS VEGAS, NV 89144-0577
(517) 899-5453
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD60179402
WA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301090230
MI
Other
Enumeration date
07/03/2007
Last updated
09/30/2020
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