Provider Demographics
NPI:1346496999
Name:CHU, HA BICH (MD)
Entity type:Individual
Prefix:
First Name:HA
Middle Name:BICH
Last Name:CHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8121 MADISON BLVD STE 101A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2082
Mailing Address - Country:US
Mailing Address - Phone:256-325-6499
Mailing Address - Fax:
Practice Address - Street 1:8121 MADISON BLVD STE 101A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2082
Practice Address - Country:US
Practice Address - Phone:256-325-6499
Practice Address - Fax:256-325-3195
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086071207Q00000X
GA61952207Q00000X
AL33557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA01285126OtherAMERIGROUP
GA137805007AMedicaid
GA509463OtherWELLCARE