Provider Demographics
NPI:1710926878
Name:CHOU, DAVID S (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:CHOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHIH-WEI
Other - Middle Name:DAVID
Other - Last Name:CHOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5225 23RD AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7927
Practice Address - Country:US
Practice Address - Phone:701-417-2535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND113032085R0202X
LA15127R2085R0202X
CAA659452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A659450OtherBLUE SHIELD OF CA
LA4F262OtherMEDICARE PROVIDER NUMBER
CA00A659450Medicaid
LA1158267Medicaid
CAWA65945CMedicare PIN
H61116Medicare UPIN
CAP00260436Medicare PIN
LA4F262OtherMEDICARE PROVIDER NUMBER
CAWA65945FMedicare PIN
CAP00041427Medicare PIN
CAWA65945GMedicare PIN
CAWA65945EMedicare PIN