Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 108742 | MO |
NPI | 1023056355 |
---|---|
Provider Name | Michael B Chen |
First Address | Saint Louis, MO 63141-8573 |
Second Address | O Fallon, MO 63368-2206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 12/02/2021 |