Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | MC0219 | ID |
NPI | 1083825509 |
---|---|
Provider Name | Dr. Maggie Chen |
First Address | Coeur D Alene, ID 83814-6051 |
Second Address | Coeur D Alene, ID 83814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 15/07/2019 |