Provider Demographics
NPI:1922269349
Name:CHEN, WAYNE CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:CHARLES
Last Name:CHEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 STEUBENVILLE PIKE
Mailing Address - Street 2:STE 101
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1353
Mailing Address - Country:US
Mailing Address - Phone:412-787-7766
Mailing Address - Fax:412-787-0370
Practice Address - Street 1:6000 STEUBENVILLE PIKE
Practice Address - Street 2:STE 101
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1353
Practice Address - Country:US
Practice Address - Phone:412-787-7766
Practice Address - Fax:412-787-0370
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2016-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256166-1208000000X
PAOS015689208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102624698Medicaid