Provider Demographics
NPI:1932149036
Name:CHEN, THOMAS T (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:T
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 1:14416 W MEEKER BLVD
Mailing Address - Street 2:BLDG C STE 301
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375
Mailing Address - Country:US
Mailing Address - Phone:623-876-3880
Mailing Address - Fax:623-285-2710
Practice Address - Street 1:14416 W MEEKER BLVD
Practice Address - Street 2:BLDG C
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5284
Practice Address - Country:US
Practice Address - Phone:623-876-3880
Practice Address - Fax:623-583-5230
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32325207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ880767Medicaid
AZ880767Medicaid
AZZ78156Medicare PIN
AZH22492Medicare UPIN
AZP00115204Medicare PIN