Individual
CHARLES CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16600 W SPRAGUE RD STE 120, MIDDLEBURG HEIGHTS, OH 44130-6300
(248) 434-6169
Mailing address
PO BOX 639295 DEPT 92294, CINCINNATI, OH 45263-9295
(248) 434-6169
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35061824C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000315125
ANTHEM BCBS
OH
05
—
0872006
—
OH
Enumeration date
08/08/2006
Last updated
11/08/2023
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