1942297833 NPI number — DR. RENEE HUI-CHUN CHEN-LEE D.O.

Table of content: DR. RENEE HUI-CHUN CHEN-LEE D.O. (NPI 1942297833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942297833 NPI number — DR. RENEE HUI-CHUN CHEN-LEE D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEN-LEE
Provider First Name:
RENEE
Provider Middle Name:
HUI-CHUN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHEN
Provider Other First Name:
RENEE
Provider Other Middle Name:
HUI-CHUN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942297833
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9910 FRANKLIN SQUARE DR # 2110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21236-4902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-933-5412
Provider Business Mailing Address Fax Number:
410-933-1390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
618 I ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-842-1118
Provider Business Practice Location Address Fax Number:
202-842-4449
Provider Enumeration Date:
10/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  0102050258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: DO 31502 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 027139300 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5861136 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 71050003 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 337640 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 773701701 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500133 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7164169 . This is a "AETNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 337641 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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