Individual
JIE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
230 BOWDOIN ST, DORCHESTER, MA 02122-1817
(177) 540-1006
Mailing address
230 BOWDOIN ST, DORCHESTER, MA 02122-1817
(617) 754-0100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
287703
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
03/02/2022
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