Provider Demographics
NPI:1063403988
Name:CHIU, EDWARD KIN (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:KIN
Last Name:CHIU
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:PO BOX 2049
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0224
Mailing Address - Country:US
Mailing Address - Phone:304-242-3043
Mailing Address - Fax:304-242-1422
Practice Address - Street 1:1307 MT DECHANTAL RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-242-3043
Practice Address - Fax:304-242-1422
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20810207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1812304000Medicaid
WV1812304000Medicaid
WV4073272Medicare ID - Type Unspecified