Healthcare Provider Details

I. General information

NPI: 1144482738
Provider Name (Legal Business Name): BRIAN CHOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 10/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 E BROAD ST SUITE 1400
COLUMBUS OH
43215-3842
US

IV. Provider business mailing address

20 E HUBBARD AVE APT 308
COLUMBUS OH
43215-0010
US

V. Phone/Fax

Practice location:
  • Phone: 614-228-7231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number123411
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number257295
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberD76133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: