Provider Demographics
NPI:1427338268
Name:CHAN, YAT HEI (PHARMD)
Entity type:Individual
Prefix:
First Name:YAT HEI
Middle Name:
Last Name:CHAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:BERNARD
Other - Middle Name:
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13894 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1803
Mailing Address - Country:US
Mailing Address - Phone:734-285-9496
Mailing Address - Fax:734-285-9498
Practice Address - Street 1:13894 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1803
Practice Address - Country:US
Practice Address - Phone:734-285-9496
Practice Address - Fax:734-285-9498
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist