Provider Demographics
NPI:1609071190
Name:CHEN, ZHAOMING (MDPHD)
Entity Type:Individual
Prefix:DR
First Name:ZHAOMING
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MDPHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 WILKENS AVE STE 430
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5073
Mailing Address - Country:US
Mailing Address - Phone:667-234-8444
Mailing Address - Fax:667-234-8432
Practice Address - Street 1:3407 WILKENS AVE STE 430
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5073
Practice Address - Country:US
Practice Address - Phone:667-234-8444
Practice Address - Fax:667-234-8432
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00667722084N0400X, 2084N0600X, 2084S0012X
VA01012407662084N0400X, 2084N0600X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW662/0250OtherCAREFIRST-REGIONAL
MDW662/0250OtherCAREFIRST-REGIONAL
MDK519126962YSMMedicare PIN