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Contact Information

JACK CHEN, MD
2355 HWY 36 W
STE. 100
ROSEVILLE, MN55113
 Phone: 651-292-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for JACK CHEN · (Male)

NPI # 1104356500
Status Active
Credentials MD
Entity Individual
Enumeration date 06/18/2017
Last updated 07/31/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 74190
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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