MEDICARE: LEI 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	207VX0000X	Obstetrics Physician	MD070734L	PA

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	:	1578628806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEI CHEN MD

Provider Business Mailing Address
First Line	:	761 JOHNSONBURG RD
Second Line	:
City	:	ST MARYS
State	:	PA
Zip	:	15857-3480
Country	:	US
Telephone Number	:	814-834-6139
Fax Number	:	814-781-3571

Provider Business Practice Location Address
First Line	:	761 JOHNSONBURG RD
Second Line	:
City	:	ST MARYS
State	:	PA
Zip	:	15857-3480
Country	:	US
Telephone Number	:	814-834-6139
Fax Number	:	814-781-3571

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	07/09/2007

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Directions to “ LEI CHEN MD” Practice Location

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