Provider Demographics
NPI:1568485159
Name:CHU, QUYEN DINH (MD)
Entity Type:Individual
Prefix:DR
First Name:QUYEN
Middle Name:DINH
Last Name:CHU
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 1:2041 GEORGIA AVE NW # 2322
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20060-0001
Mailing Address - Country:US
Mailing Address - Phone:202-865-4903
Mailing Address - Fax:202-865-3131
Practice Address - Street 1:2041 GEORGIA AVE NW # 2322
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-2134
Practice Address - Country:US
Practice Address - Phone:202-865-4903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME154104208600000X
LA14685R208600000X
LA014685R2086X0206X
DCMD2100123422086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1130737Medicaid
LA4E743F610Medicare ID - Type Unspecified
LAH76049Medicare UPIN