Provider Demographics
NPI:1003283672
Name:CHEN, REBEKAH (PA-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7671 QUARTERFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4407
Mailing Address - Country:US
Mailing Address - Phone:410-766-0111
Mailing Address - Fax:
Practice Address - Street 1:7671 QUARTERFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4407
Practice Address - Country:US
Practice Address - Phone:443-351-3376
Practice Address - Fax:410-582-9155
Is Sole Proprietor?:No
Enumeration Date:2015-08-30
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001005772363A00000X
MDC06573363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant