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General NPI Number Information
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NPI Number | 1306874169
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Entity Type | Individual
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Provider Name | ANNIE WAIFONG CHAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 100 BLOSSOMS STREET COX LL MASSACHUSETTS GENERAL HOSPITAL,
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City | BOSTON
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State | MA
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Zip | 02114
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Country | US
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Telephone | 617-724-1159
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Fax | 617-726-3603
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Provider Business Mailing Address
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Address Line | 55 FRUIT STREET COX 337 MASSACHUSETTS GENERAL HOSPITAL
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City | BOSTON
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State | MA
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Zip | 02114
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Country | US
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Telephone | 617-724-1159
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Fax | 617-726-3603
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 205315
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License Number State | MA
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