Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 039740 | CT |
N | 207RC0200X | Critical Care Medicine | 216379 | MA |
N | 207RP1001X | Pulmonary Disease | 039740 | CT |
Y | 207RP1001X | Pulmonary Disease | 216379 | MA |
NPI | 1083604870 |
---|---|
Provider Name | Chih Ming Chen |
First Address | Springfield, MA 01104-3300 |
Second Address | Springfield, MA 01104-3300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 24/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2103532 | (05) | MA |
36379 | HEALTH NEW ENGLAND (01) | MA |
459459 | TUFTS HEALTH PLAN (01) | MA |
I10730 | (02) | |
J28918 | BLUE CROSS BLUE SHIELD (01) | MA |