Provider Demographics
NPI:1629125737
Name:SIU, SAMUEL CHI BUN (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL CHI BUN
Middle Name:
Last Name:SIU
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:TORONTO GENERAL HOSPITAL
Mailing Address - Street 2:PMCC3-526
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M5G2C4
Mailing Address - Country:CA
Mailing Address - Phone:416-340-3095
Mailing Address - Fax:
Practice Address - Street 1:TORONTO GENERAL PMCC 3-526
Practice Address - Street 2:200 ELIZABETH STREET
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M5G2C4
Practice Address - Country:CA
Practice Address - Phone:416-340-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59650207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease