Healthcare Provider Details

I. General information

NPI: 1982760419
Provider Name (Legal Business Name): DANIAL LUFTI CHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8991 REDDEN RD
BRIDGEVILLE DE
19933-4746
US

IV. Provider business mailing address

8991 REDDEN RD
BRIDGEVILLE DE
19933-4746
US

V. Phone/Fax

Practice location:
  • Phone: 302-337-3300
  • Fax: 302-337-8072
Mailing address:
  • Phone: 302-337-3300
  • Fax: 302-337-8072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC10007847
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC1-0007847
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: