Provider Demographics
NPI:1275524456
Name:CHEN, WENLIANG (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:WENLIANG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 RESNIK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-5880
Mailing Address - Fax:508-746-8847
Practice Address - Street 1:45 RESNIK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-746-5880
Practice Address - Fax:508-746-8847
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224211208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ28916OtherBCBS MA
MA408032OtherTUFTS HEALTH PLAN
MAAA101110OtherHARVARD PILGRIM HEALTHCAR
MA4359725OtherAETNA
MA000000034358OtherBMC HEALTHNET
MA2105691Medicaid
MAJ28916OtherBCBS MA
MA2105691Medicaid
MAA38568Medicare PIN