Provider Demographics
NPI:1154342772
Name:CHEN, MIKE KUANG SING (MD)
Entity type:Individual
Prefix:
First Name:MIKE
Middle Name:KUANG SING
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:KUANG SING
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:ACC 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-939-9688
Mailing Address - Fax:205-975-4972
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:ACC 300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9688
Practice Address - Fax:205-975-4972
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL296532086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259040900Medicaid
AL051065714OtherBCBS AL
MS08384254OtherMISSISSIPPI MEDICAID
AL114137Medicaid
FL259040900Medicaid
FL68641Medicare ID - Type Unspecified
AL051065714OtherBCBS AL
F61680Medicare UPIN