Provider Demographics
NPI:1023195914
Name:EDWARD K. CHIU, MD, INC
Entity Type:Organization
Organization Name:EDWARD K. CHIU, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-242-3043
Mailing Address - Street 1:PO BOX 2049
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2049
Mailing Address - Country:US
Mailing Address - Phone:304-242-3043
Mailing Address - Fax:304-242-1422
Practice Address - Street 1:1021 MT DECHANTAL RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-242-3043
Practice Address - Fax:304-242-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20810207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9355641Medicare ID - Type UnspecifiedCORP - MEDICARE #