Individual
MARK M CHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1103 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 760-8488
(573) 756-3793
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(573) 760-8488
(573) 756-3793
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36657
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202709200
—
MO
Enumeration date
05/26/2006
Last updated
02/17/2012
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