| Berming Pan Md Inc | |
|
306 Ohio St Wanatah IN 46390-0367 | |
| (219) 733-2755 | |
| (219) 733-2377 |
| Full Name | Berming Pan Md Inc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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 |