Provider Demographics
NPI:1912369471
Name:CHEN, WINSOR
Entity Type:Individual
Prefix:
First Name:WINSOR
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 CLIFTON ROAD NE
Mailing Address - Street 2:BUILDING A, ROOM 2200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-727-1994
Mailing Address - Fax:404-251-0604
Practice Address - Street 1:1365 CLIFTON ROAD NE
Practice Address - Street 2:BUILDING A, ROOM 2200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-727-1994
Practice Address - Fax:404-251-0604
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1501422086S0129X
390200000X
GA140842086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program