Provider Demographics
NPI:1063587830
Name:CHOU, MIKE WOOLIANG (MD)
Entity type:Individual
Prefix:DR
First Name:MIKE
Middle Name:WOOLIANG
Last Name:CHOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1110 PROFESSIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-8002
Mailing Address - Country:US
Mailing Address - Phone:812-401-7577
Mailing Address - Fax:812-401-5342
Practice Address - Street 1:1110 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-8002
Practice Address - Country:US
Practice Address - Phone:812-401-7577
Practice Address - Fax:812-401-5342
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01058048A207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200883070Medicaid
G13334Medicare UPIN
IN200883070Medicaid