Healthcare Provider Details

I. General information

NPI: 1861527418
Provider Name (Legal Business Name): MARCUS YEN-TA CHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DRIVE MSC 1061 BUILDING 10, ROOM B1D416
BETHESDA MD
20892-1061
US

IV. Provider business mailing address

10 CENTER DRIVE MSC 1061 BUILDING 10, ROOM B1D416
BETHESDA MD
20892-1061
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-3658
  • Fax: 301-402-2389
Mailing address:
  • Phone: 301-496-3658
  • Fax: 301-402-2389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0064693
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0064693
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberD0064693
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberD0064693
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: