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NPI Code Detail

MEDICARE: DR. TIM HC PAN DO

MEDICARE:  DR. TIM HC PAN  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician5101012786MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245235332
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIM HC PAN DO
Provider Business Mailing Address
First Line : PO BOX 5649
Second Line :
City : SAGINAW
State : MI
Zip : 48603-0649
Country : US
Telephone Number : 989-797-2400
Fax Number : 989-249-1035
Provider Business Practice Location Address
First Line : 1601 MARQUETTE ST
Second Line : STE 1
City : BAY CITY
State : MI
Zip : 48706-4196
Country : US
Telephone Number : 989-671-2550
Fax Number : 989-671-2545
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 04/07/2021

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Directions to “ DR. TIM HC PAN DO” Practice Location

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