Individual
CHARLIE C PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, B2 FLOOR UNIVERSITY HOSPITAL RM C490, ANN ARBOR, MI 48109-0010
(734) 936-4300
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
4301074664
MI
2085R0001X
Radiation Oncology Physician
Primary
54475-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4660707
—
MI
Enumeration date
09/29/2006
Last updated
12/16/2019
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