MEDICARE: DR. TAMMY T CHEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	31361	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AA42659325	OTHER	SC	MCR PTAN

General Provider Information

NPI Number	:	1013055706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMMY T CHEN M.D.

Provider Business Mailing Address
First Line	:	2424 INDIA HOOK RD
Second Line	:	SUITE 120
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2784
Country	:	US
Telephone Number	:	803-328-8255
Fax Number	:	803-328-8265

Provider Business Practice Location Address
First Line	:	2424 INDIA HOOK RD
Second Line	:	SUITE 120
City	:	ROCK HILL
State	:	SC
Zip	:	29732-2784
Country	:	US
Telephone Number	:	803-328-8255
Fax Number	:	803-328-8265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	01/23/2013

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