Provider Demographics
NPI:1477634467
Name:CYNTHIA CHOW, M.D., P.C.
Entity Type:Organization
Organization Name:CYNTHIA CHOW, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-651-1001
Mailing Address - Street 1:1419 WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1775
Mailing Address - Country:US
Mailing Address - Phone:248-651-1001
Mailing Address - Fax:248-651-1002
Practice Address - Street 1:1419 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1775
Practice Address - Country:US
Practice Address - Phone:248-651-1001
Practice Address - Fax:248-651-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301025962207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0706313891OtherBLUE CROSS BLUE SHIELD MI
MI1631389Medicare ID - Type Unspecified
MIB43076Medicare UPIN