Healthcare Provider Details

I. General information

NPI: 1023195914
Provider Name (Legal Business Name): EDWARD K. CHIU, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 MT DECHANTAL RD
WHEELING WV
26003
US

IV. Provider business mailing address

PO BOX 2049
WHEELING WV
26003-2049
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-3043
  • Fax: 304-242-1422
Mailing address:
  • Phone: 304-242-3043
  • Fax: 304-242-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number20810
License Number StateWV

VIII. Authorized Official

Name: DR. EDWARD K CHIU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-242-3043