Provider Demographics
NPI:1811210701
Name:LAU, COREY CHUEN-YEN (MD)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:CHUEN-YEN
Last Name:LAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHUEN-YEN
Other - Middle Name:COREY
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1600 E GUDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1341
Mailing Address - Country:US
Mailing Address - Phone:301-251-5023
Mailing Address - Fax:301-251-5020
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:DEPT OF INTERNAL MEDICINE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-0196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0068816171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider