Berming Pan Md Inc | |
306 Ohio St Wanatah IN 46390-0367 | |
(219) 733-2755 | |
(219) 733-2377 |
Full Name | Berming Pan Md Inc |
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Speciality | Family Medicine |
Location | 306 Ohio St, Wanatah, Indiana |
Authorized Official Name and Position | Chen-tsu Pan (MEDICAL DOCTOR) |
Authorized Official Contact | 7024864255 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Berming Pan Md Inc Po Box 367 Wanatah IN 46390-0367 Ph: (219) 733-2755 | Berming Pan Md Inc 306 Ohio St Wanatah IN 46390-0367 Ph: (219) 733-2755 |
NPI Number | 1649453226 |
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Provider Enumeration Date | 12/06/2007 |
Last Update Date | 01/07/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649453226 | NPI | - | NPPES |
000000084157 | Other | IN | BCBS |
100163680A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |