Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 29653 | AL |
NPI | 1154342772 |
---|---|
Provider Name | Mike Kuang Sing Chen |
First Address | Birmingham, AL 35233-1711 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 07/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051065714 | BCBS AL (01) | AL |
08384254 | MISSISSIPPI MEDICAID (01) | MS |
114137 | (05) | AL |
259040900 | (05) | FL |
F61680 | (02) |