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NPI Code Detail

MEDICARE: CONNIE CHIN MD

MEDICARE: CONNIE CHIN 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
1208000000XPediatrics Physician35.134466OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770858870
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE CHIN MD
Provider Business Mailing Address
First Line : PO BOX 933421
Second Line :
City : CLEVELAND
State : OH
Zip : 44193-0039
Country : US
Telephone Number : 937-641-3000
Fax Number :
Provider Business Practice Location Address
First Line : 8501 OLD TROY PIKE
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-1054
Country : US
Telephone Number : 937-641-4360
Fax Number : 937-641-3791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2012
Last Update Date : 02/13/2026

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Directions to “ CONNIE CHIN MD” Practice Location

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