Provider Demographics
NPI:1881772283
Name:CHAN, MAREN M (MD)
Entity type:Individual
Prefix:MS
First Name:MAREN
Middle Name:M
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAREN
Other - Middle Name:M
Other - Last Name:TWEDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9225 MARYMONT PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217
Mailing Address - Country:US
Mailing Address - Phone:617-319-6667
Mailing Address - Fax:
Practice Address - Street 1:8534 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5501
Practice Address - Country:US
Practice Address - Phone:617-319-6667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8771207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology