Provider Demographics
NPI:1770566903
Name:HU, JEFFREY TZU-LIANG (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TZU-LIANG
Last Name:HU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 63112
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3112
Mailing Address - Country:US
Mailing Address - Phone:336-274-9617
Mailing Address - Fax:336-482-2177
Practice Address - Street 1:1331 NORTH ELM STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6304
Practice Address - Country:US
Practice Address - Phone:336-274-9617
Practice Address - Fax:336-482-2177
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98013042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1770566903Medicaid
NC1072COtherBLUE CROSS BLUE SHIELD
NC1600534OtherUNITED HEALTHCARE
NC30012OtherPARTNERS
NC891072CMedicaid
NC300126751OtherRAILROAD MEDICARE
NCB1747OtherMEDCOST
VA1770566903Medicaid
NC1600534OtherUNITED HEALTHCARE