Provider Demographics
NPI:1932203221
Name:CHU, STEPHEN S (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:S
Last Name:CHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1571
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21501-1571
Mailing Address - Country:US
Mailing Address - Phone:301-723-4965
Mailing Address - Fax:301-723-4983
Practice Address - Street 1:600 MEMORIAL LN
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:301-723-4965
Practice Address - Fax:301-723-4983
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD13722207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS516F212Medicare UPIN