Provider Demographics
NPI:1700317930
Name:CHU, QIAO ANGELA (BHSC, MD)
Entity Type:Individual
Prefix:DR
First Name:QIAO
Middle Name:ANGELA
Last Name:CHU
Suffix:
Gender:F
Credentials:BHSC, MD
Other - Prefix:
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Mailing Address - Street 1:110 W SQUANTUM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2122
Mailing Address - Country:US
Mailing Address - Phone:617-376-3000
Mailing Address - Fax:617-774-1905
Practice Address - Street 1:110 W SQUANTUM ST
Practice Address - Street 2:
Practice Address - City:NORTH QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2122
Practice Address - Country:US
Practice Address - Phone:617-376-3000
Practice Address - Fax:617-774-1905
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ103979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine