Provider Demographics
NPI:1427281013
Name:CHAN, JAMES S (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:158 W NEW ENGLAND AV
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3540
Mailing Address - Country:US
Mailing Address - Phone:614-787-1392
Mailing Address - Fax:
Practice Address - Street 1:262 N MAN ST ADVANTAGE CARE NA LLC DBA MONROE URGENT CA
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050
Practice Address - Country:US
Practice Address - Phone:513-461-2273
Practice Address - Fax:513-461-2639
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-28
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-098637207Q00000X
OH35.098637207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0070601Medicaid