Provider Demographics
NPI:1316130743
Name:CHEN, TAO (MD)
Entity type:Individual
Prefix:
First Name:TAO
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 1:1557 SPRING HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-3218
Mailing Address - Country:US
Mailing Address - Phone:251-478-4900
Mailing Address - Fax:251-470-6221
Practice Address - Street 1:1557 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3218
Practice Address - Country:US
Practice Address - Phone:251-478-4900
Practice Address - Fax:251-470-6221
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL296012081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL185242Medicaid