Provider Demographics
NPI:1730380056
Name:CHEN, KUN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KUN
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 BELLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-1783
Mailing Address - Country:US
Mailing Address - Phone:256-551-6510
Mailing Address - Fax:256-704-7095
Practice Address - Street 1:4606 BELLEWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-1783
Practice Address - Country:US
Practice Address - Phone:256-551-6510
Practice Address - Fax:256-704-7095
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244162207R00000X
AL30159207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL120602Medicaid
AL120602Medicaid