Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Clark C Chen, MDPHD

Individual provider Neurological Surgery Physician · NPI 1437149523

Dr. Clark C Chen, MDPHD is a Neurosurgery in Providence, Rhode Island. Graduated from Harvard Medical School in 2001, 25 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts, Minnesota and Rhode Island.

Years since qualifying
25
Trained at
Harvard Medical School
Licensed in
MA, MN, RI
In the registry since
2005
Specialties on file
3
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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 793-9166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 909 Fulton St Se, Minneapolis, MN 55455-4800 — (612) 672-7422

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence MD19577 (RI)
Neurological Surgery Physician Taxonomy 207T00000X · Licence 216069 (MA)
Neurological Surgery Physician Taxonomy 207T00000X · Licence 62432 (MN)

Record details

NPI number1437149523
Entity typeIndividual (Type 1)
GenderMale
Credentials MDPHD
Sole proprietorYes
NPI enumeratedOctober 28, 2005
Last updated in NPPESMay 7, 2024
Certification dateMay 7, 2024
Mailing addressPo Box 232410, San Diego, CA 92193-2410

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROSURGERY
Medical schoolHARVARD MEDICAL SCHOOL
Graduated 2001 (25 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence