Healthcare Provider Details

I. General information

NPI: 1205939840
Provider Name (Legal Business Name): JIMMY D CHUA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 SAVANNAH RD
LEWES DE
19958-1611
US

IV. Provider business mailing address

1535 SAVANNAH RD
LEWES DE
19958-1611
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-3232
  • Fax: 302-645-3833
Mailing address:
  • Phone: 302-645-3232
  • Fax: 302-645-3833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberC1-0026391
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: