Provider Demographics
NPI:1639188675
Name:CHEN, ALICE L (MS)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:L
Last Name:CHEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10320 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:STE A
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2128
Mailing Address - Country:US
Mailing Address - Phone:410-750-2666
Mailing Address - Fax:410-480-3455
Practice Address - Street 1:10320 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:STE A
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2128
Practice Address - Country:US
Practice Address - Phone:410-750-2666
Practice Address - Fax:410-480-3455
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00480171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1290310OtherUNITED HEALTHCARE
MDBF72ALOtherNCAS
MDS2150001OtherCAREFIRST BLUECHOICE
MD255684OtherMAMSI
MDBF72ALOtherCAREFIRST BLUE CROSS BLUE
MD255684OtherALLIANCE
MD125667OtherJOHNS HOPKINS