Provider Demographics
NPI:1659455160
Name:CHEN, YAN (MD)
Entity Type:Individual
Prefix:DR
First Name:YAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YAN
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1001 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3316
Mailing Address - Country:US
Mailing Address - Phone:304-697-4497
Mailing Address - Fax:304-523-9470
Practice Address - Street 1:1001 10TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3316
Practice Address - Country:US
Practice Address - Phone:304-697-4497
Practice Address - Fax:304-523-9470
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22657207ZP0102X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4208551Medicare PIN