Provider Demographics
NPI:1952628620
Name:CHU, BRADFORD J (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:J
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 1:2530 CHICAGO AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4289
Mailing Address - Country:US
Mailing Address - Phone:612-813-8800
Mailing Address - Fax:
Practice Address - Street 1:2530 CHICAGO AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4289
Practice Address - Country:US
Practice Address - Phone:612-813-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264663208000000X
MN613982080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics