Provider Demographics
NPI:1598126609
Name:CHU, JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
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:III MEF FORCE SURGEONS OFFICE
Mailing Address - Street 2:UNIT 35605
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96382-5605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:III MEF FORCE SURGEONS OFFICE
Practice Address - Street 2:UNIT 35605
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96382-5605
Practice Address - Country:US
Practice Address - Phone:315-622-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101263006207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine