Provider Demographics
NPI:1205828597
Name:CHEN, STEVEN B (DPM)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:CHEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:XENG
Other - Middle Name:B
Other - Last Name:SAETANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:934 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2502
Mailing Address - Country:US
Mailing Address - Phone:610-527-8656
Mailing Address - Fax:610-527-8346
Practice Address - Street 1:934 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2502
Practice Address - Country:US
Practice Address - Phone:610-527-8656
Practice Address - Fax:610-527-8346
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003800L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01534350Medicaid
PA5309160001Medicare NSC
PA01534350Medicaid
PACH601190Medicare PIN
PA6169460001Medicare NSC