Provider Demographics
NPI:1841302114
Name:VO, CHAN P (MD)
Entity type:Individual
Prefix:DR
First Name:CHAN
Middle Name:P
Last Name:VO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2900 LEMAY FERRY RD
Mailing Address - Street 2:SUITE #226
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125
Mailing Address - Country:US
Mailing Address - Phone:314-894-9192
Mailing Address - Fax:314-894-3210
Practice Address - Street 1:2900 LEMAY FERRY RD
Practice Address - Street 2:SUITE #226
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125
Practice Address - Country:US
Practice Address - Phone:314-894-9192
Practice Address - Fax:314-894-3210
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-09-26
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Provider Licenses
StateLicense IDTaxonomies
MO36643207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202885208Medicaid
MO000005787Medicare ID - Type Unspecified
MO202885208Medicaid