Martin Kin Chan, PHARMD, JD

Individual provider Active NPI Pharmacist · Travelers Rest, SC

NPI 1053559161 · NPPES record last updated Jan 27, 2009

Key facts

NPI
1053559161
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
011942 (SC)
Practice address
119 Newkirk Way
Travelers Rest, SC 29690-8344
Phone
(864) 551-3868
NPI assigned
Jan 27, 2009
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Juris Doctor, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
011942SCMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 011942 SC Yes

Addresses

Primary practice location

119 Newkirk Way
Travelers Rest, SC 29690-8344

Mailing address

119 Newkirk Way
Travelers Rest, SC 29690-8344
Phone (864) 551-3868

Other providers in Travelers Rest, SC

All providers in Travelers Rest, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.