Individual
DR. KENNETH KWOK-CHUN CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ANDOVER PEDIATRICS NPI 1548393176, 203 TURNPIKE ST, SUITE 200, NORTH ANDOVER, MA 01845
(978) 475-4522
(978) 475-6531
Mailing address
ANDOVER PEDIATRICS NPI 1548393176, 203 TURNPIKE ST, SUITE 200, NORTH ANDOVER, MA 01845
(978) 475-4522
(978) 475-6531
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
205542
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0124010
—
MA
05
—
11002050A
—
MA
Enumeration date
07/14/2005
Last updated
11/15/2024
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