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General NPI Number Information
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NPI Number | 1568819308
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Entity Type | Individual
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Provider Name | YUJUN GAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DR DEPT OF
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City | LEBANON
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State | NH
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Zip | 03756-1000
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Country | US
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Telephone | 603-650-5000
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 2016015535
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 22392
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License Number State | NH
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