Provider Demographics
NPI:1306807599
Name:CHEN, XIONGYING (MD)
Entity type:Individual
Prefix:
First Name:XIONGYING
Middle Name:
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 1:500 EASTERN BLVD 200
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2044
Mailing Address - Country:US
Mailing Address - Phone:334-399-5427
Mailing Address - Fax:
Practice Address - Street 1:1725 PINE ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1109
Practice Address - Country:US
Practice Address - Phone:334-293-8000
Practice Address - Fax:334-293-8067
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00022773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51003135OtherBCBS
ALP00294532OtherRAIL ROAD MEDICARE
AL009934547Medicaid
AL009934547Medicaid
ALH12148Medicare UPIN