MEDICARE: KELVIN LIN-YU CHOU 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
1	174400000X	Specialist	MD11423	RI
2	2084N0400X	Neurology Physician	4301091116	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29880	OTHER	RI	NEIGHBORHOOD HEALTH
2	050513332	OTHER	RI	UNITED HEALTHCARE
3	050513332	OTHER	RI	OXFORD
4	1376539791	OTHER	RI	NPI
5	411652	OTHER	RI	BLUE CHIP
6	29649	OTHER	RI	BLUECROSS BLUESHIELD RI
7	050513332	OTHER	RI	PHCS
8	050513332	OTHER	RI	TRICARE
9	3957622	OTHER	RI	AETNA
10	469157	OTHER	RI	TUFTS
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	2113376	OTHER	RI	MASSHEATLH
13	AA29804	OTHER	RI	PILGRIM

General Provider Information

NPI Number	:	1376539791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELVIN LIN-YU CHOU MD

Provider Business Mailing Address
First Line	:	3621 S STATE ST
Second Line	:	700 KMS PLACE
City	:	ANN ARBOR
State	:	MI
Zip	:	48108
Country	:	US
Telephone Number	:	734-936-2047
Fax Number	:

Provider Business Practice Location Address
First Line	:	4260 PLYMOUTH RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-2700
Country	:	US
Telephone Number	:	734-764-6831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	04/16/2015

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