Healthcare Provider Details

I. General information

NPI: 1770523466
Provider Name (Legal Business Name): SARA CHUA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA CHUA-DILLY DO

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CORTLAND ACRES LN
THOMAS WV
26292-8066
US

IV. Provider business mailing address

25 W BLUEMONT ST
GRAFTON WV
26354-1242
US

V. Phone/Fax

Practice location:
  • Phone: 304-463-3331
  • Fax: 304-463-3338
Mailing address:
  • Phone: 304-265-0312
  • Fax: 304-265-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1847
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: