Healthcare Provider Details

I. General information

NPI: 1790952869
Provider Name (Legal Business Name): ADRIAN OMAR CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 WOLLARD BLVD
RICHMOND MO
64085-2229
US

IV. Provider business mailing address

9411 N OAK TRFY STE LL1
KANSAS CITY MO
64155-2262
US

V. Phone/Fax

Practice location:
  • Phone: 816-776-2201
  • Fax: 816-776-7678
Mailing address:
  • Phone: 816-691-1655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2012004024
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2012004024
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: