Individual
CHUNG MING CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.,B.S.
Contact information
Practice address
3450 HULL RD, BOX 112727, GAINESVILLE, FL 32607-4144
(352) 273-7001
Mailing address
2603 NW 13TH ST, PMB 251, GAINESVILLE, FL 32609-2835
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME118688
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021309100
—
FL
01
—
JA171Z
MEDICARE PTAN
FL
Enumeration date
08/10/2009
Last updated
08/04/2017
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