Provider Demographics
NPI:1881190361
Name:UY, FERDINAND CHIANG (PT)
Entity Type:Individual
Prefix:MR
First Name:FERDINAND
Middle Name:CHIANG
Last Name:UY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 S PENINSULA RD
Mailing Address - Street 2:
Mailing Address - City:EAST JORDAN
Mailing Address - State:MI
Mailing Address - Zip Code:49727-9410
Mailing Address - Country:US
Mailing Address - Phone:231-536-2286
Mailing Address - Fax:231-536-2476
Practice Address - Street 1:1728 S PENINSULA RD
Practice Address - Street 2:
Practice Address - City:EAST JORDAN
Practice Address - State:MI
Practice Address - Zip Code:49727-9410
Practice Address - Country:US
Practice Address - Phone:231-536-2286
Practice Address - Fax:231-536-2476
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010114142251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501011414Medicaid