Provider Demographics
NPI:1215904305
Name:CHEN, MICHAEL FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FRANCIS
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 1:3000 OLD CENTRE RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-4883
Mailing Address - Country:US
Mailing Address - Phone:269-250-4556
Mailing Address - Fax:855-930-1409
Practice Address - Street 1:3000 OLD CENTRE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4883
Practice Address - Country:US
Practice Address - Phone:269-250-4556
Practice Address - Fax:855-930-1409
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071254208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1215904305Medicaid
MI1034122770Medicaid
MI1215904305Medicaid
MI280C96122OtherBCBS MI
MI1034122770Medicaid
G32224Medicare UPIN
MI1215904305Medicaid