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General NPI Number Information
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NPI Number | 1891732863
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Entity Type | Individual
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Provider Name | YONGJIN CHEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 10803 MAIN ST
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City | MANTUA
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State | OH
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Zip | 44255-9695
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Country | US
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Telephone | 330-274-2030
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Fax | 330-274-2151
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Provider Business Mailing Address
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Address Line | 10803 MAIN ST
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City | MANTUA
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State | OH
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Zip | 44255-8602
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Country | US
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Telephone | 330-274-2030
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Fax | 330-274-2151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-088152
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License Number State | OH
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