Provider Demographics
NPI:1356392856
Name:CHEN, NANCY (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
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:PO BOX 1076
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-1076
Mailing Address - Country:US
Mailing Address - Phone:770-532-7179
Mailing Address - Fax:770-534-1312
Practice Address - Street 1:743 SPRING ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3715
Practice Address - Country:US
Practice Address - Phone:770-532-7179
Practice Address - Fax:770-534-1312
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA50872207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000969592BMedicaid
GAP0027702OtherRAILROAD MEDICARE ID#
GAG98069Medicare UPIN
GAP0027702OtherRAILROAD MEDICARE ID#