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General NPI Number Information
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NPI Number | 1487969903
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Entity Type | Organization
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Legal Business Name | YUNG C. CHAN, M.D. P.C.
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 101 1ST ST NW
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City | PULASKI
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State | VA
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Zip | 24301-5605
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Country | US
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Telephone | 540-980-0550
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Fax | 540-980-5010
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Provider Business Mailing Address
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Address Line | 101 1ST ST NW
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City | PULASKI
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State | VA
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Zip | 24301-5605
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Country | US
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Telephone | 540-980-0550
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Fax | 540-980-5010
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Authorized Official
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Title or Position | INSURANCE CLERK
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Name | MRS. CAROLYN P GARDNER
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Credential |
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Telephone | 540-980-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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