Provider Demographics
NPI:1992227508
Name:CHU, SHIRLYNN ALTHEA (MD)
Entity type:Individual
Prefix:
First Name:SHIRLYNN ALTHEA
Middle Name:
Last Name:CHU
Suffix:
Gender:F
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:PO BOX 11392
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4004
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:239-348-2147
Practice Address - Street 1:8831 FOUNDERS SQUARE DRIVE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:239-348-2147
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144798207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program