Healthcare Provider Details

I. General information

NPI: 1093770406
Provider Name (Legal Business Name): KATHRINA L CHUA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST FL 2
DOVER DE
19901-3530
US

IV. Provider business mailing address

640 S. STATE STREET, MAIL CODE 3055
DOVER DE
19901
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-7994
  • Fax: 302-744-7993
Mailing address:
  • Phone: 302-744-7994
  • Fax: 302-744-7993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberC1-0007819
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberC1-0007819
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: