Chan, Kenneth Kwok-Chun
Chan, Kenneth Kwok-Chun is an individual health care provider with primary practice located at 140 Haverhill St , Andover MA 01810-1504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Chan, Kenneth Kwok-Chun can be contacted via phone (978) 475-4522.Contact Information
Primary practice address
140 Haverhill St
Andover MA 01810-1504
Phone: (978) 475-4522
Fax: (978) 475-6531
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 205542 | Massachusetts |
Profile Details
| NPI number | 1639178460 |
|---|---|
| LBN Legal business name | Chan, Kenneth Kwok-Chun |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639178460 | NPPES |
| Massachusetts | MEDICAID | 0124010 |
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