Provider Demographics
NPI:1518065630
Name:CHAU, WING C (MD)
Entity Type:Individual
Prefix:DR
First Name:WING
Middle Name:C
Last Name:CHAU
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 1:943 STEVENS DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3508
Mailing Address - Country:US
Mailing Address - Phone:509-943-1211
Mailing Address - Fax:509-946-9090
Practice Address - Street 1:943 STEVENS DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3508
Practice Address - Country:US
Practice Address - Phone:509-943-1211
Practice Address - Fax:509-946-9090
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1104041Medicaid
F55388Medicare UPIN
AB03348Medicare ID - Type Unspecified