Provider Demographics
NPI:1669812251
Name:CHEN, ZHONGCHUAN WILL (MD)
Entity Type:Individual
Prefix:DR
First Name:ZHONGCHUAN
Middle Name:WILL
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 1:10150 102 ST NW #200
Mailing Address - Street 2:C/O MEDICAL AFFAIRS
Mailing Address - City:EDMONTON
Mailing Address - State:AB
Mailing Address - Zip Code:T5J 5E2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10150 102 ST NW #200
Practice Address - Street 2:C/O MEDICAL AFFAIRS
Practice Address - City:EDMONTON
Practice Address - State:AB
Practice Address - Zip Code:T5J 5E2
Practice Address - Country:CA
Practice Address - Phone:780-451-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ023970207ZP0101X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematologyGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty