Provider Demographics
NPI:1205939840
Name:CHUA, JIMMY D (MD)
Entity type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:D
Last Name:CHUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1535 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1611
Mailing Address - Country:US
Mailing Address - Phone:302-645-3232
Mailing Address - Fax:302-645-3833
Practice Address - Street 1:1535 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1611
Practice Address - Country:US
Practice Address - Phone:302-645-3232
Practice Address - Fax:302-645-3833
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0026391207RI0200X
WAMD00039395207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1205939840Medicaid
WAG8901443Medicare PIN
WA1205939840Medicaid