Basic Information
| Provider Information | |||||||||
| NPI: | 1407850274 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHU | ||||||||
| FirstName: | HUEY | ||||||||
| MiddleName: | WILLY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 FIRSTVILLAGE DRIVE | ||||||||
| Address2: | PO BOX 2000 | ||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102956831 | ||||||||
| FaxNumber: | 9102950244 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 FIRSTVILLAGE DRIVE | ||||||||
| Address2: | |||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102354023 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2005 | ||||||||
| LastUpdateDate: | 09/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 0000-39404 | NC | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 79011P9 | 05 | NC | MEDICAID |