Healthcare Provider Details

I. General information

NPI: 1326742602
Provider Name (Legal Business Name): AMELIA NGUYET CHU AUSTIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 HEMLOCK ST
MACON GA
31201-2102
US

IV. Provider business mailing address

1080 LUMPKIN CAMPGROUND RD S STE 300
DAWSONVILLE GA
30534-0989
US

V. Phone/Fax

Practice location:
  • Phone: 478-301-5824
  • Fax: 478-301-5825
Mailing address:
  • Phone: 706-265-4100
  • Fax: 706-265-4132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15037
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: