Provider Demographics
NPI:1679711519
Name:WILLIAM T. CHEN MEDICAL, INC.
Entity Type:Organization
Organization Name:WILLIAM T. CHEN MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WT
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-421-8800
Mailing Address - Street 1:33 STANIFORD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3105
Mailing Address - Country:US
Mailing Address - Phone:401-421-8800
Mailing Address - Fax:401-273-6510
Practice Address - Street 1:33 STANIFORD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3105
Practice Address - Country:US
Practice Address - Phone:401-421-8800
Practice Address - Fax:401-273-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI10419207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty