Provider Demographics
NPI:1386806768
Name:CHE, CHAU (MD)
Entity type:Individual
Prefix:
First Name:CHAU
Middle Name:
Last Name:CHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2301 E ALLEGHENY AVE
Mailing Address - Street 2:190B
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4427
Mailing Address - Country:US
Mailing Address - Phone:215-926-3120
Mailing Address - Fax:215-926-3123
Practice Address - Street 1:2301 E ALLEGHENY AVE
Practice Address - Street 2:190B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4427
Practice Address - Country:US
Practice Address - Phone:215-926-3120
Practice Address - Fax:215-926-3123
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD452023207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACD4829OtherTPI RAILROAD MEDICARE GROUP
PA1007278000OtherTPI MEDICAID GROUP
PA597586OtherTPI MEDICARE GROUP