Provider Demographics
NPI:1376710707
Name:CHEN, HAN KUANG (MD)
Entity Type:Individual
Prefix:DR
First Name:HAN
Middle Name:KUANG
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 1:1900 S MISSOURI AVE
Mailing Address - Street 2:APT. #3128
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-3308
Mailing Address - Country:US
Mailing Address - Phone:307-277-4147
Mailing Address - Fax:
Practice Address - Street 1:1900 S MISSOURI AVE
Practice Address - Street 2:APT. #3128
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-3308
Practice Address - Country:US
Practice Address - Phone:307-277-4147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7874A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine