Provider Demographics
NPI:1124056312
Name:CHEN, JAMES Z (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:Z
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 1:14014 CAMBERRA CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3305
Mailing Address - Country:US
Mailing Address - Phone:314-469-6893
Mailing Address - Fax:
Practice Address - Street 1:14014 CAMBERRA CT
Practice Address - Street 2:CHEN'S RADIATION
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3305
Practice Address - Country:US
Practice Address - Phone:314-469-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR96202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201056025Medicaid
IL2440268002Medicaid
MOP00241513Medicare ID - Type UnspecifiedRAILROAD
MO201056025Medicaid
A09842Medicare UPIN