Provider Demographics
NPI:1659322659
Name:CHIANG, FU-YU (MD)
Entity Type:Individual
Prefix:
First Name:FU-YU
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SAM PERRY BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4467
Mailing Address - Country:US
Mailing Address - Phone:540-374-3277
Mailing Address - Fax:540-374-3280
Practice Address - Street 1:130 EXECUTIVE CENTER PKWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3100
Practice Address - Country:US
Practice Address - Phone:540-370-4468
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-14
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234153207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010106036Medicaid
00W143M03Medicare ID - Type Unspecified