Individual
DR. CARLYLE H CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 N MAYFAIR RD FL 3, MILWAUKEE, WI 53226-3464
(414) 955-8900
(414) 955-6285
Mailing address
1155 N MAYFAIR RD FL 3, MILWAUKEE, WI 53226-3464
(414) 955-8900
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22994
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000112G
HUMANA
—
05
—
1528019924
—
WI
05
—
30353500
—
WI
Enumeration date
05/12/2006
Last updated
01/19/2024
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