Provider Demographics
NPI:1811967789
Name:CHEN, CASIE (MD)
Entity type:Individual
Prefix:DR
First Name:CASIE
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2 S CASCADE AVE
Mailing Address - Street 2:140
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1624
Mailing Address - Country:US
Mailing Address - Phone:719-866-6568
Mailing Address - Fax:719-538-2996
Practice Address - Street 1:700 W US HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-8975
Practice Address - Country:US
Practice Address - Phone:719-522-1133
Practice Address - Fax:719-687-8919
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0040913207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00424838Medicaid
CO00424838Medicaid
H51270Medicare UPIN