Healthcare Provider Details

I. General information

NPI: 1518191782
Provider Name (Legal Business Name): RICK CHIEN-AN CHEN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 E FIRE TOWER RD
GREENVILLE NC
27858-4105
US

IV. Provider business mailing address

1432 E FIRE TOWER RD
GREENVILLE NC
27858-4105
US

V. Phone/Fax

Practice location:
  • Phone: 252-439-1150
  • Fax: 252-439-1152
Mailing address:
  • Phone: 252-439-1150
  • Fax: 252-439-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number581
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: