Active NPI
Huai C Pan, MD
- Plastic Surgery Physician
- Fairfield, OH
National Provider Identifier
1124098215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 41823
- Practice address
- 2960 Mack Rd
Suite 212
Fairfield, OH 45014-5373 - Phone
- (513) 874-0808
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 41823 | OH | Primary |
Addresses
Primary practice location
2960 Mack Rd
Suite 212
Fairfield, OH 45014-5373
Mailing address
2960 Mack Rd
Suite 212
Fairfield, OH 45014-5373
Phone (513) 874-0808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41823 | OH | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1124098215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2960 MACK RD",
"address_2": "SUITE 212",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450145373",
"telephone_number": "513-874-0808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 MACK RD",
"address_2": "SUITE 212",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450145373",
"telephone_number": "513-874-0808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "HUAI",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "OH",
"license": "41823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.