Provider Demographics
NPI:1295818599
Name:CHEN, DOUGLAS A (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E. NORTH AVE.
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-321-2480
Mailing Address - Fax:412-321-4207
Practice Address - Street 1:420 E NORTH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4746
Practice Address - Country:US
Practice Address - Phone:412-321-2480
Practice Address - Fax:412-321-4207
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025303E207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011027940001Medicaid
PA143167OtherHIGHMARK BLUE SHIELD
PA143167NKDMedicare ID - Type Unspecified
PA143167OtherHIGHMARK BLUE SHIELD