CHARLIE C PAN (NPI# 1407948805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407948805 |
| Entity Type | Individual |
| Full Name | CHARLIE C PAN |
| Credential | MD |
| Practice Address |
1500 East Medical Center Dr B2 Floor University Hospital Rm C490 Ann Arbor MI 48109-0010 |
| Mailing Address |
Po Box 22487 Green Bay WI 54305-2487 |
| Practice Telephone | 7349364300 |
| Mailing Telephone | 9204457222 |
| Mailing Fax Number | 9204457289 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2019-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
54475-20 | WI | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
4301074664 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4660707 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1580 Commanche Ave, Green Bay, WI 543135751 | 9204358326 | 9204304659 |
| Street Address |
1500 EAST MEDICAL CENTER DR B2 FLOOR UNIVERSITY HOSPITAL RM C490 |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-0010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417731 | Daniel William Berland | Internal Medicine | 1500 East Medical Center Dr, 3rd Floor Taubman Ctr Recp B, Ann Arbor, MI 48109-5352 | 2005-06-17 |
| 1770105405 | Emily Ager | Student in an Organized Health Care Education/Training Program | 1500 East Medical Center Dr, B1-380 Taubman Center, Ann Arbor, MI 48109-5305 | 2020-05-15 |
| 1922668987 | Matthew James Wolf | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-20 |
| 1235799644 | Helen Elizabeth Mulcahy | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-18 |
| 1679133490 | Alexander Charles Waselewski | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-14 |
| 1043870868 | Danielle Rose Vanbeckum | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-14 |
| 1881254621 | Megan Kathryn Zakerski | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-14 |
| 1104484625 | Alicia Isabelle Rolin | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-05-30 |
| 1417515933 | Kristen Elizabeth Unsicker | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-05-30 |
| 1760040273 | Katie Christine Ramos | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
| Find all providers in zip 48109 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013329382 | Jaipreet S Suri | Radiology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-05-21 |
| 1265852362 | William Carl Jackson | Radiology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-04-16 |
| 1609131523 | Stuart E Samuels | Radiology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2012-07-06 |
| 1891052262 | Daniel Richard Wahl | Radiology | 1500 E Medical Center Dr, B2 Floor University Hospital Rm C490, Ann Arbor, MI 48109-5010 | 2012-04-23 |
| 1861759029 | Enid W Choi | Radiology | 1500 East Medical Center Dr, B2 Floor University Hospital Rm C490, Ann Arbor, MI 48109-5010 | 2012-04-12 |
| 1336415439 | Christina Hunter Chapman | Radiology | 1500 E Medical Center Dr, B2 Floor University Hospital Rm C490, Ann Arbor, MI 48109-5010 | 2012-03-22 |
| 1366731838 | Brandon Robert Mancini | Radiology | 1500 E Medical Center Drive, B2 Floor University Hospital Rm C490, Ann Arbor, MI 48109-5010 | 2011-04-05 |
| 1497044085 | David Alan Elliott | Radiology | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2011-04-04 |
| 1780905901 | Daniel E Spratt | Radiology | 1500 E Medical Center Drive, B2 Floor University Hospital Rm C490, Ann Arbor, MI 48109-5010 | 2010-06-22 |
| 1932429172 | Corey Wayne Speers | Radiology | 1500 E Medical Center Dr, B2 Floor University Hospital Rm C490, Ann Arbor, MI 48109-5010 | 2010-06-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.