Provider Demographics
NPI:1144324591
Name:CHEN, YUEGANG (PA-C)
Entity type:Individual
Prefix:MR
First Name:YUEGANG
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 FELDSPA LN.
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-7639
Mailing Address - Country:US
Mailing Address - Phone:336-285-0870
Mailing Address - Fax:
Practice Address - Street 1:1052 FELDSPA LN.
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27023-7639
Practice Address - Country:US
Practice Address - Phone:336-285-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104094363AS0400X
FLPA 9103116363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical