Provider Demographics
NPI:1952338592
Name:CHAN, CLARA (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7001 BYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3166
Mailing Address - Country:US
Mailing Address - Phone:301-656-1831
Mailing Address - Fax:301-656-1903
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:SUITE 337
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:301-681-4600
Practice Address - Fax:301-681-4648
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41828207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3601884OtherUNITED HEALTHCARE
MD910976OtherMAMSI
MDOC22CSOtherCAREFIRST BCBS OF MARYLAN
0004140133OtherAETNA
3000099OtherAMERICHOICE
DC50740001OtherBCBS NATIONAL CAPITAL ARE
DC673016Medicare ID - Type UnspecifiedTRAILBLAZER DC METRO
3601884OtherUNITED HEALTHCARE