Russell Chan, DO

Emergency Medicine in Lawrenceville, GA. Individual provider (NPI-1).

NPI number1801213640

StatusActive

Last updated in NPPESSep 18, 2025

Details

NPI: 1801213640
Entity type: Individual (NPI-1)
Name: Russell Chan
Credential: DO
Sex: Male
Sole proprietor: Yes
Enumeration date: Mar 18, 2014
Certification date: Sep 18, 2025
Last updated: Sep 18, 2025

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - EMERGENCY MEDICINE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207P00000X	Emergency Medicine	84279	GA	Yes

Practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Phone 678-312-1000

Mailing address

100 Madison Ave
Morristown, NJ 07960-6136

Phone 973-971-7926 · Fax 973-290-7202

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Emergency Medicine Physician providers in Lawrenceville, GA

All 44 Emergency Medicine Physician providers in Lawrenceville · All 5,967 providers in Lawrenceville

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