Provider Demographics
NPI:1922082270
Name:CHU, ALEX (DO)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:CHU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 CASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-3215
Mailing Address - Country:US
Mailing Address - Phone:215-744-6061
Mailing Address - Fax:215-000-0000
Practice Address - Street 1:6100 CASTOR AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-3215
Practice Address - Country:US
Practice Address - Phone:215-744-6061
Practice Address - Fax:215-000-0000
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-006940-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine