Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | D89742 | MD |
Y | 207RP1001X | Pulmonary Disease | D89742 | MD |
N | 207RP1001X | Pulmonary Disease | MD436457 | PA |
NPI | 1063561694 |
---|---|
Provider Name | Minghui Fan |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Cumberland, MD 21502-6491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 18/06/2020 |