Healthcare Provider Details

I. General information

NPI: 1659515344
Provider Name (Legal Business Name): JOANNE CHIU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2009
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST BLOOMBERG CHILDRENS CENTER M2306
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

PO BOX 64316
BALTIMORE MD
21264-4316
US

V. Phone/Fax

Practice location:
  • Phone: 443-287-0526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD82236
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberD82236
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: