Healthcare Provider Details
I. General information
NPI: 1841642634
Provider Name (Legal Business Name): SARAH E CHEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/06/2016
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
725 VOLVO PKWY STE 100
CHESAPEAKE VA
23320-1621
US
IV. Provider business mailing address
11761 ROCK LANDING DR STE 8
NEWPORT NEWS VA
23606-4235
US
V. Phone/Fax
- Phone: 757-548-0076
- Fax: 757-548-1652
- Phone: 757-232-8769
- Fax: 757-232-8875
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 0102206369 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 5101022449 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0102206369 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: