Provider Demographics
NPI:1538171921
Name:CHIU, ERIC K (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:K
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 1:12990 MANCHESTER RD STE 202
Mailing Address - Street 2:DES PERES EYE CENTER
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1860
Mailing Address - Country:US
Mailing Address - Phone:314-432-6137
Mailing Address - Fax:314-432-1237
Practice Address - Street 1:12990 MANCHESTER RD STE 202
Practice Address - Street 2:DES PERES EYE CENTER
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1860
Practice Address - Country:US
Practice Address - Phone:314-432-6137
Practice Address - Fax:314-432-1237
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY241356207W00000X
IL36117039207W00000X
MO2013007992207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK40178Medicare PIN
MOP00422969Medicare PIN
MO990000015Medicare PIN
ILI71157Medicare UPIN
MOL71157Medicare UPIN
ILP00422969Medicare PIN