Provider Demographics
NPI:1366692956
Name:CHEN, WEN YEN (MD)
Entity Type:Individual
Prefix:DR
First Name:WEN
Middle Name:YEN
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 1:330 W MARINE CORPS DR
Mailing Address - Street 2:
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929-5929
Mailing Address - Country:US
Mailing Address - Phone:671-637-8112
Mailing Address - Fax:671-637-8113
Practice Address - Street 1:330 W MARINE CORPS DR
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-5929
Practice Address - Country:US
Practice Address - Phone:671-637-8112
Practice Address - Fax:671-637-8113
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU417208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics