Provider Demographics
NPI:1144359977
Name:CHEN, ROLAND N (MD)
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:N
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-5000
Mailing Address - Fax:775-883-4677
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9262208800000X
NH23271208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002013270Medicaid
NV340017601OtherRR MEDICARE
NVNV0152OtherANTHEM BCBS NEVADA
NV33142Medicare ID - Type UnspecifiedDAYTON MEDICARE
NV33144Medicare ID - Type UnspecifiedMINDEN MEDICARE
NV340017601OtherRR MEDICARE
NVF77153Medicare UPIN
NV33139Medicare ID - Type UnspecifiedCARSON CITY MEDICARE
NV002013270Medicaid
NVNV0152OtherANTHEM BCBS NEVADA
NV33142Medicare ID - Type UnspecifiedFALLON MEDICARE