Healthcare Provider Details

I. General information

NPI: 1871750695
Provider Name (Legal Business Name): BRIAN LIANG-YU CHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 HENRY ST
GREENSBORO NC
27405-3633
US

IV. Provider business mailing address

1200 N ELM ST
GREENSBORO NC
27401-1004
US

V. Phone/Fax

Practice location:
  • Phone: 336-621-3777
  • Fax: 336-621-8374
Mailing address:
  • Phone: 336-832-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2011-00302
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0101267038
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2011-00302
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: