MEDICARE: STANLEY MICHEL CHEN CARDENAS 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	207R00000X	Internal Medicine Physician	P28819	MD
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	4301514872	MI

General Provider Information

NPI Number	:	1194163519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STANLEY MICHEL CHEN CARDENAS MD

Provider Business Mailing Address
First Line	:	3621 S STATE ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-1633
Country	:	US
Telephone Number	:	734-647-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 W MICHIGAN AVE
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-5443
Country	:	US
Telephone Number	:	734-647-5871
Fax Number	:

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

Provider Enumeration Date	:	06/07/2013
Last Update Date	:	08/27/2025

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