Healthcare Provider Details

I. General information

NPI: 1215904305
Provider Name (Legal Business Name): MICHAEL FRANCIS CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 OLD CENTRE RD
PORTAGE MI
49024-4883
US

IV. Provider business mailing address

3000 OLD CENTRE RD
PORTAGE MI
49024-4883
US

V. Phone/Fax

Practice location:
  • Phone: 269-250-4556
  • Fax: 855-930-1409
Mailing address:
  • Phone: 269-250-4556
  • Fax: 855-930-1409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number4301071254
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4301071254
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: