Pan, Shijun
Pan, Shijun is an sole proprietor health care provider with primary practice located at 535 S Ferdon Blvd Ste C , Crestview FL 32536-4446. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Pan, Shijun can be contacted via phone (850) 423-4664.Contact Information
Primary practice address
535 S Ferdon Blvd Ste C
Crestview FL 32536-4446
Phone: (850) 423-4664
Fax: (850) 398-8824
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 26567 | South Carolina |
| Other Service Providers / Specialist | 174400000X | ME99122 | Florida |
Profile Details
| NPI number | 1245280858 |
|---|---|
| LBN Legal business name | Pan, Shijun |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 12th, 2006 |
| Last updated | Oct 1st, 2012 - about 13 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 | 1245280858 | NPPES |
| Florida | MEDICAID | 279656200 |
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