Healthcare Provider Details

I. General information

NPI: 1194103614
Provider Name (Legal Business Name): KIN WAH CHEW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2015
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1590
US

IV. Provider business mailing address

22 S GREENE ST
BALTIMORE MD
21201-1590
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6152
  • Fax: 410-328-3758
Mailing address:
  • Phone: 410-328-6152
  • Fax: 410-328-3758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0091783
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT208497
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberD0091783
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: