Provider Demographics
NPI:1457318941
Name:CHU, MICHELLE TRAM ANH NGOC (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:TRAM ANH NGOC
Last Name:CHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:T
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6400 SEVEN CORNERS PL
Mailing Address - Street 2:SUITE J
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2009
Mailing Address - Country:US
Mailing Address - Phone:703-241-8008
Mailing Address - Fax:703-241-0062
Practice Address - Street 1:6400 SEVEN CORNERS PL
Practice Address - Street 2:SUITE J
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2009
Practice Address - Country:US
Practice Address - Phone:703-241-8008
Practice Address - Fax:703-241-0062
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010035180Medicaid
VA010035180Medicaid