Individual
DR. SIU FUNG CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 558-4194
(513) 558-0995
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5502
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35.120331
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
35.120331
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109159
—
OH
05
—
201157060
—
IN
05
—
7100313840
—
KY
Enumeration date
03/26/2009
Last updated
06/07/2017
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