Individual
FANGXIANG CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10012 KENNERLY RD, STE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
(314) 543-5994
Mailing address
10012 KENNERLY RD, STE 400, SAINT LOUIS, MO 63128-2197
(314) 543-5999
(314) 543-5994
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
2011015498
MO
207T00000X
Neurological Surgery Physician
39180
IA
207T00000X
Neurological Surgery Physician
43769
AZ
207T00000X
Neurological Surgery Physician
R-7468
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156440052
MEDICARE PTAN
MO
Enumeration date
05/17/2007
Last updated
05/15/2024
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