Provider Demographics
NPI: | 1982604005 |
---|---|
Name: | CHOW, ARTHUR YICHIA (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | ARTHUR |
Middle Name: | YICHIA |
Last Name: | CHOW |
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: | 2800 BLUE RIDGE RD STE 400 |
Mailing Address - Street 2: | |
Mailing Address - City: | RALEIGH |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27607-6477 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-787-5380 |
Mailing Address - Fax: | 919-784-5605 |
Practice Address - Street 1: | 2800 BLUE RIDGE RD STE 400 |
Practice Address - Street 2: | |
Practice Address - City: | RALEIGH |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27607-6477 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-787-5380 |
Practice Address - Fax: | 919-784-5605 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-07-29 |
Last Update Date: | 2021-06-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 2005-00902 | 207R00000X, 207RC0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | 5900963 | Medicaid | |
NC | 5900963 | Medicaid | |
NC | I32344 | Medicare UPIN |