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NPI 1063849552

NPI 1063849552 : BRIAN TZE-KIT CHIU PA-C : HOLLY, MI

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General NPI Number Information
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    NPI Number           |    1063849552
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN TZE-KIT CHIU PA-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/30/2013
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    Last Update Date     |    12/06/2019
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Provider Practice Location Address
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    Address Line         |    3523 GRANGE HALL RD 
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    City                 |    HOLLY
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    State                |    MI
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    Zip                  |    48442-1007
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    Country              |    US
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    Telephone            |    248-382-5791
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3523 GRANGE HALL RD 
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    City                 |    HOLLY
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    State                |    MI
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    Zip                  |    48442-1007
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    Country              |    US
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    Telephone            |    248-382-5791
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    020516-1
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    License Number State |    NY
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Taxonomy #3
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    5601006864
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    License Number State |    MI
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