Healthcare Provider Details

I. General information

NPI: 1568668432
Provider Name (Legal Business Name): GEOFFREY CHU CHIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE DEPARTMENT OF ENDOCRINOLOGY, DIABETES AND METABOLISM
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-5165
  • Fax: 301-295-5170
Mailing address:
  • Phone: 301-295-5165
  • Fax: 301-295-5170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0101244829
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: