Provider Demographics
NPI:1073740890
Name:CHEN, CHUN-CHENG (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUN-CHENG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8109
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-5298
Mailing Address - Fax:314-362-5743
Practice Address - Street 1:4901 FOREST PARK AVE STE 420
Practice Address - Street 2:STE 420
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1453
Practice Address - Country:US
Practice Address - Phone:314-362-5298
Practice Address - Fax:314-362-5743
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2018-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20120261142086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care