Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 43876 | MN |
NPI | 1013980440 |
---|---|
Provider Name | Zongyu J Chen |
First Address | Minneapolis, MN 55414-0909 |
Second Address | Coon Rapids, MN 55433-5897 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 21/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
291910900 | (05) | MN |
H39359 | (02) | MN |