MEDICARE: DR. KWONG-HON CHOW MD, PHD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207T00000X	Neurological Surgery Physician	DR.0064263	CO

General Provider Information

NPI Number	:	1578906392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KWONG-HON CHOW MD, PHD

Provider Business Mailing Address
First Line	:	340 EXEMPLA CIR STE 300
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-3384
Country	:	US
Telephone Number	:	303-673-1390
Fax Number	:	720-627-6407

Provider Business Practice Location Address
First Line	:	340 EXEMPLA CIR STE 300
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-3384
Country	:	US
Telephone Number	:	303-673-1390
Fax Number	:	720-627-6407

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

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	04/20/2023

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