Provider Demographics
NPI:1144202995
Name:CHEN, EDWIN T (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:T
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:97 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4373
Practice Address - Country:US
Practice Address - Phone:301-663-4545
Practice Address - Fax:301-663-1709
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2018-10-01
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Provider Licenses
StateLicense IDTaxonomies
MDD0043309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD181701900Medicaid
MDF43969Medicare UPIN
MD181701900Medicaid