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NPI Code Detail

MEDICARE: DR. NANCY FAN MD

MEDICARE: DR. NANCY FAN MD
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
1207V00000XObstetrics & Gynecology PhysicianC1-0005037DE

General Provider Information

NPI Number : 1336142751
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY FAN MD
Provider Business Mailing Address
First Line : PO BOX 824804
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19182-4804
Country : US
Telephone Number : 302-575-8226
Fax Number : 302-575-8342
Provider Business Practice Location Address
First Line : 532 GREENHILL AVE
Second Line :
City : WILMINGTON
State : DE
Zip : 19805-1851
Country : US
Telephone Number : 302-778-2229
Fax Number : 302-504-5010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 05/17/2021

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