1922145119 NPI number — DR. CELIA SHIN-WEN CHEN MD, MPH

Table of content: DR. CELIA SHIN-WEN CHEN MD, MPH (NPI 1922145119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922145119 NPI number — DR. CELIA SHIN-WEN CHEN MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEN
Provider First Name:
CELIA
Provider Middle Name:
SHIN-WEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
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:
CELIA
Provider Other Middle Name:
SHIN-WEN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1922145119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 NORTH WOLFE STREET
Provider Second Line Business Mailing Address:
MAUMENEE 127
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-955-8679
Provider Business Mailing Address Fax Number:
410-614-9240

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 N WOLFE STREET MAUMENEE
Provider Second Line Business Practice Location Address:
MAUMENEE 127
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-955-8679
Provider Business Practice Location Address Fax Number:
410-614-9240
Provider Enumeration Date:
01/30/2007

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: 207W00000X , with the licence number:  P21340 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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