Provider Demographics
NPI:1477558658
Name:CHU, PAUL REN (MD)
Entity Type:Individual
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First Name:PAUL
Middle Name:REN
Last Name:CHU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:19550 E 39TH ST S
Mailing Address - Street 2:STE. 220
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2358
Mailing Address - Country:US
Mailing Address - Phone:816-461-6837
Mailing Address - Fax:816-833-1760
Practice Address - Street 1:19550 E 39TH ST S
Practice Address - Street 2:STE. 220
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2358
Practice Address - Country:US
Practice Address - Phone:816-461-6837
Practice Address - Fax:816-833-1760
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2022-02-09
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Provider Licenses
StateLicense IDTaxonomies
MO102011207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208512418Medicaid
MO208512418Medicaid
MOJ384068Medicare ID - Type Unspecified