Provider Demographics
NPI:1295821882
Name:CHAN, STANLEY UY (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:UY
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 1:1500 CHESTNUT ST
Mailing Address - Street 2:APT #6C
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2737
Mailing Address - Country:US
Mailing Address - Phone:314-853-3123
Mailing Address - Fax:
Practice Address - Street 1:1500 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1200
Practice Address - Country:US
Practice Address - Phone:610-237-4814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030129452085R0202X
PAMD4342192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology