MEDICARE: DR. SUE SI 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	2085R0202X	Diagnostic Radiology Physician	MD457286	PA
2	2085R0202X	Diagnostic Radiology Physician	DR.0066434	CO

General Provider Information

NPI Number	:	1295024735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUE SI CHEN M.D.

Provider Business Mailing Address
First Line	:	11700 W 2ND PL STE 100
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-1707
Country	:	US
Telephone Number	:	720-321-0401
Fax Number	:

Provider Business Practice Location Address
First Line	:	11700 W 2ND PL STE 100
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-1707
Country	:	US
Telephone Number	:	720-321-0401
Fax Number	:

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

Provider Enumeration Date	:	04/05/2011
Last Update Date	:	02/27/2023

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