Provider Demographics
NPI:1790952869
Name:CHEN, ADRIAN OMAR (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:OMAR
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 1:9411 N OAK TRFY STE LL1
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-691-1655
Mailing Address - Fax:
Practice Address - Street 1:902 WOLLARD BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-2229
Practice Address - Country:US
Practice Address - Phone:816-776-2201
Practice Address - Fax:816-776-7879
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012004024208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics