Provider Demographics
NPI:1902910458
Name:CHEN, GRACE L (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:L
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5214 SANGAMORE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2322
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:415-520-0904
Practice Address - Street 1:5214 SANGAMORE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2322
Practice Address - Country:US
Practice Address - Phone:415-658-6791
Practice Address - Fax:415-520-0904
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251716207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherCIGNA
VA1902910458OtherCOVENTRY HEALTH NETWORK
VA1902910458Medicaid
VA1902910458OtherVIRGINIA PREMIER HEALTH PLAN
VAPAROtherUSA MANAGED CARE
VAPAROtherMULTIPLAN
VA-032OtherTRICARE/CHAMPUS
VA1902910458OtherUNITED HEALTHCARE
VAPAROtherAETNA
VA10093667OtherOPTIMA HEALTH
VA472496OtherANTHEM BC/BS
NC5920233Medicaid
VAPAROtherCORVEL
VAPAROtherVIRGINIA HEALTH NETWORK
VA10093667OtherOPTIMA HEALTH
VA1902910458Medicaid