Healthcare Provider Details

I. General information

NPI: 1235135476
Provider Name (Legal Business Name): ANDREW L CHEN M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 PROFILE ROAD
FRANCONIA NH
03580
US

IV. Provider business mailing address

PO BOX 160
LITTLETON NH
03561-0160
US

V. Phone/Fax

Practice location:
  • Phone: 603-823-8600
  • Fax: 603-823-8688
Mailing address:
  • Phone: 603-823-8600
  • Fax: 603-823-8688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number12418
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number12418
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: