Provider Demographics
NPI:1487636429
Name:CHEN, DAVID WILBUR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILBUR
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:43 WESTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3451
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:MGH, WANG 835
Practice Address - Street 2:55 FRUIT STREET
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-5533
Practice Address - Fax:617-726-6991
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2174342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ26378OtherBCBS MS
MA467873OtherTUFTS HEALTH PLAN
MA2098423Medicaid
MA2098423Medicaid
H88787Medicare UPIN