Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 34.004211 | OH |
NPI | 1366481822 |
---|---|
Provider Name | Vincent K Chu |
First Address | Westerville, OH 43082-8348 |
Second Address | Westerville, OH 43082-8348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 18/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0719173 | (05) | OH |
A17489 | (02) |