Basic Information
| Provider Information | |||||||||
| NPI: | 1265993828 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHU | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | KAIYI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER | ||||||||
| Address2: | 395 W 12TH AVENUE | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933989 | ||||||||
| FaxNumber: | 6142939789 | ||||||||
| Practice Location | |||||||||
| Address1: | THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER | ||||||||
| Address2: | 395 W 12TH AVENUE THIRD FLOOR | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142933989 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2019 | ||||||||
| LastUpdateDate: | 07/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.144751 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RG0100X | 35.144751 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 35.144751 | 01 | OH | STATE MEDICAL LICENSE | OTHER |