Provider Demographics
NPI:1700179413
Name:CHIN, STEPHEN ALEXANDER (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALEXANDER
Last Name:CHIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9733 HEALTHWAY DR
Mailing Address - Street 2:AGH DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9733 HEALTHWAY DR
Practice Address - Street 2:AGH DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1155
Practice Address - Country:US
Practice Address - Phone:410-629-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH81265207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology