Basic Information
| Provider Information | |||||||||
| NPI: | 1871563775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHOW | ||||||||
| FirstName: | HENRY | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 MEDICAL PARK DR | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280250937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044031308 | ||||||||
| FaxNumber: | 7044031194 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 MEDICAL PARK DR | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280250937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044031308 | ||||||||
| FaxNumber: | 7044031194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 06/13/2013 | ||||||||
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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 | 207RR0500X | 9600485 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 21966 | 01 | NC | BCBS PROVIDER ID | OTHER | 8921966 | 05 | NC | MEDICAID | 2223586B | 01 | NC | MEDICARE PIN, CURRENT | OTHER |