Individual
ANDREW T CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-3212
(617) 724-6832
Mailing address
55 FRUIT ST, GRJ-722, BOSTON, MA 02114-2621
(617) 726-3212
(617) 724-6832
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
210410
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024168
NEIGHBORHOOD HEALTH PLAN
MA
05
—
0134031
—
MA
01
—
210410
TUFTS HEALTH PLAN
MA
01
—
30205076
NH MEDICAID
NH
01
—
6584416
CIGNA
—
01
—
6831017
HEALTHSOURCE
MA
01
—
994677
NETWORK HEALTH
MA
01
—
AA13929
HARVARD PILGRIM HEALTHCAR
MA
01
—
H40331
ANTHEM BLUE CROSS
NH
01
—
J23432
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/22/2005
Last updated
08/04/2010
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