NPI Code Details Logo

NPI 1992110316

NPI 1992110316 : EDWARD YUDER CHEN M.D. : GRAND RAPIDS, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1992110316
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    EDWARD YUDER CHEN M.D.
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/24/2014
-----------------------------------------------------
    Last Update Date     |    10/31/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    275 MICHIGAN ST NE 
-----------------------------------------------------
    City                 |    GRAND RAPIDS
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    49503-2531
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    616-267-7900
-----------------------------------------------------
    Fax                  |    616-267-7901
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    100 MICHIGAN ST NE # MC845 
-----------------------------------------------------
    City                 |    GRAND RAPIDS
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    49503-2560
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2084E0001X
-----------------------------------------------------
    Taxonomy Name        |    Epilepsy Physician
-----------------------------------------------------
    License Number       |    4301503795
-----------------------------------------------------
    License Number State |    MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    2084N0600X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Neurophysiology Physician
-----------------------------------------------------
    License Number       |    25MA12688600
-----------------------------------------------------
    License Number State |    NJ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    2084N0600X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Neurophysiology Physician
-----------------------------------------------------
    License Number       |    4301503795
-----------------------------------------------------
    License Number State |    MI
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.