Provider Demographics
NPI:1982760419
Name:CHAN, DANIAL LUFTI (MD)
Entity type:Individual
Prefix:DR
First Name:DANIAL
Middle Name:LUFTI
Last Name:CHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8991 REDDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19933-4746
Mailing Address - Country:US
Mailing Address - Phone:302-337-3300
Mailing Address - Fax:302-337-8072
Practice Address - Street 1:8991 REDDEN RD
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-4746
Practice Address - Country:US
Practice Address - Phone:302-337-3300
Practice Address - Fax:302-337-8072
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007847207R00000X
DEC1-0007847208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000039657Medicaid
DE1000039657Medicaid
DE019108K16Medicare ID - Type Unspecified