Healthcare Provider Details

I. General information

NPI: 1164658639
Provider Name (Legal Business Name): QI CHEN M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 PROSPECT BLVD STE L
FREDERICK MD
21701-6430
US

IV. Provider business mailing address

8518 POSTOAK RD
POTOMAC MD
20854-3547
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-3001
  • Fax:
Mailing address:
  • Phone: 410-627-3994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD72980
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberD72980
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: