Basic Information
| Provider Information | |||||||||
| NPI: | 1285736116 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | AMY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1365A CLIFTON RD NE | ||||||||
| Address2: | DEPARTMENT OF OTOLARYNGOLOGY | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047783381 | ||||||||
| FaxNumber: | 4047784295 | ||||||||
| Practice Location | |||||||||
| Address1: | 1365A CLIFTON RD NE | ||||||||
| Address2: | DEPARTMENT OF OTOLARYNGOLOGY | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047783381 | ||||||||
| FaxNumber: | 4047784295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 50350 | GA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.