Provider Demographics
NPI:1851369391
Name:CHU, THOMAS PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PAUL
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 1:520 TRINITY CREEK CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-2279
Mailing Address - Country:US
Mailing Address - Phone:901-755-2511
Mailing Address - Fax:901-758-1965
Practice Address - Street 1:520 TRINITY CREEK CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-2279
Practice Address - Country:US
Practice Address - Phone:901-755-2511
Practice Address - Fax:901-758-1965
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000016690207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4263550OtherAETNA PROVIDER #
TN0158276OtherBC/BS PROVIDER #
TN2687986OtherCIGNA PROVIDER #
TN0158276OtherBC/BS PROVIDER #