Provider Demographics
NPI:1326048554
Name:CHOW, CYNTHIA TSENG (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:TSENG
Last Name:CHOW
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 1:43151 DALCOMA DR STE 4
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6306
Mailing Address - Country:US
Mailing Address - Phone:586-286-8720
Mailing Address - Fax:586-286-8723
Practice Address - Street 1:43151 DALCOMA DR STE 1
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6306
Practice Address - Country:US
Practice Address - Phone:586-286-8720
Practice Address - Fax:586-286-8723
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2019-04-18
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
MI4301025962207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0706313891OtherBCBS
MI1631389Medicare ID - Type Unspecified
MI0706313891OtherBCBS