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Individual

CHI DAI CHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1040 MARLBORO WAY, SUITE 7, BENNETTSVILLE, SC 29512-2494
(843) 479-5858
(843) 454-1092
Mailing address
1040 MARLBORO WAY, SUITE 7, BENNETTSVILLE, SC 29512-2494
(843) 479-5858
(843) 454-1092

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22377
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000196767
UNISON
SC
05
223779
SC
01
407687
WELLCARE
SC
01
7162826
AETNA
SC
Enumeration date
10/26/2006
Last updated
09/17/2012
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