MEDICARE: DR. RUEY CHEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	4301043355	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598742645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUEY CHEN MD

Provider Business Mailing Address
First Line	:	PO BOX 77000
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48277-2000
Country	:	US
Telephone Number	:	800-678-1861
Fax Number	:

Provider Business Practice Location Address
First Line	:	2333 BIDDLE ST
Second Line	:
City	:	WYANDOTTE
State	:	MI
Zip	:	48192-4668
Country	:	US
Telephone Number	:	734-846-6922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	07/16/2007

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