Provider Demographics
NPI:1245890284
Name:CHAU, LUCY CHING (MD)
Entity type:Individual
Prefix:
First Name:LUCY CHING
Middle Name:
Last Name:CHAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LUCY CHING
Other - Middle Name:
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:844 W PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-1916
Mailing Address - Country:US
Mailing Address - Phone:267-694-8604
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351044642208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery