MEDICARE: HUAI C PAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	41823	OH

General Provider Information

NPI Number	:	1124098215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUAI C PAN MD

Provider Business Mailing Address
First Line	:	2960 MACK RD
Second Line	:	SUITE 212
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5373
Country	:	US
Telephone Number	:	513-874-0808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 MACK RD
Second Line	:	SUITE 212
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5373
Country	:	US
Telephone Number	:	513-874-0808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	12/26/2007

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Directions to “ HUAI C PAN MD” Practice Location

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