MEDICARE: ZONGYU J CHEN MD

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	207RG0100X	Gastroenterology Physician	43876	MN

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

General Provider Information

NPI Number	:	1013980440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZONGYU J CHEN MD

Provider Business Mailing Address
First Line	:	PO BOX 14909
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-0909
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:	612-870-5491

Provider Business Practice Location Address
First Line	:	9145 SPRINGBROOK DR
Second Line	:	#200
City	:	COON RAPIDS
State	:	MN
Zip	:	55433-5897
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:	612-870-5491

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	05/21/2014

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