Provider Demographics
NPI:1073611828
Name:CHIA, LAWRENCE A (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:A
Last Name:CHIA
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 1:6601 COLLEGE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1504
Mailing Address - Country:US
Mailing Address - Phone:913-359-6001
Mailing Address - Fax:
Practice Address - Street 1:190 N UNION ST STE 203
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1362
Practice Address - Country:US
Practice Address - Phone:330-923-3502
Practice Address - Fax:330-928-9761
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052953207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200311540Medicaid
IN000000175313OtherBLUE SHIELD - REID HOSP
OH0933208Medicaid
INP000140720Medicare Oscar/Certification
F59774Medicare UPIN
OH0933208Medicaid
IN000000175313OtherBLUE SHIELD - REID HOSP