Provider Demographics
NPI:1083825509
Name:CHEN, MAGGIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 W 50TH AVE APT 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2940
Mailing Address - Country:US
Mailing Address - Phone:720-215-2831
Mailing Address - Fax:
Practice Address - Street 1:850 W BARAGA AVE
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4550
Practice Address - Country:US
Practice Address - Phone:906-449-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMC02192080N0001X
WI2937-3202080N0001X
COCDRH.00456392080N0001X
MTMED-PHYS-LIC-884342080N0001X
MIEMC00003182080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91689511Medicaid
CO018289OtherKAISER COMMERCIAL NUMBER
COC809397Medicare PIN
CO018289OtherKAISER COMMERCIAL NUMBER