Healthcare Provider Details

I. General information

NPI: 1376591255
Provider Name (Legal Business Name): SIMING CHEN HUMMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 RONALD REAGAN PKWY STE 1540
AVON IN
46123-7085
US

IV. Provider business mailing address

1111 RONALD REAGAN PKWY STE 1540
AVON IN
46123-7085
US

V. Phone/Fax

Practice location:
  • Phone: 317-217-2211
  • Fax: 317-217-2559
Mailing address:
  • Phone: 317-217-2211
  • Fax: 317-217-2559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01049003
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: