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NPI Code Detail

MEDICARE: CHI WAN HSU MD

MEDICARE:   CHI WAN HSU  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician12901OK

General Provider Information

NPI Number : 1063505253
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHI WAN HSU MD
Provider Business Mailing Address
First Line : 2809 NW 31ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112
Country : US
Telephone Number : 405-942-7474
Fax Number : 405-942-2518
Provider Business Practice Location Address
First Line : 2809 NW 31ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112
Country : US
Telephone Number : 405-942-7474
Fax Number : 405-942-2518
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 07/08/2007

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