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General NPI Number Information
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NPI Number | 1710135363
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Entity Type | Individual
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Provider Name | MARCIA SUM-WING CHAN MD
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Gender | Female
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 1501 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85724-0001
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Country | US
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Telephone | 520-626-4657
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 E PIMA ST APT 185
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City | TUCSON
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State | AZ
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Zip | 85712-4364
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Country | US
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Telephone | 321-243-2203
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | R70509
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License Number State | AZ
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