Provider Demographics
NPI:1992731269
Name:CHEN, AN-YU (MD)
Entity type:Individual
Prefix:
First Name:AN-YU
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 1:1225 S.BROADWAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:859-258-4950
Mailing Address - Fax:859-258-4618
Practice Address - Street 1:1225 S.BROADWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-258-4950
Practice Address - Fax:859-258-4618
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36512207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64033384Medicaid
KY64033384Medicaid
KY36000818OtherMEDICAID ASC GROUP
KYASC1019OtherMEDICARE ASC GROUP
GACB5773OtherRR MEDICARE GROUP
GA100015279OtherRR MEDICARE PIN
KY4000501OtherMEDICARE LAB GROUP
0169Medicare PIN
KY37903705OtherMEDICAID LAB GROUP
KYASC1019OtherMEDICARE ASC GROUP