Basic Information
| Provider Information | |||||||||
| NPI: | 1932149499 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHU | ||||||||
| FirstName: | ROLAND | ||||||||
| MiddleName: | LEE-SHING | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 WOODWARD AVE | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132621490 | ||||||||
| FaxNumber: | 3132621238 | ||||||||
| Practice Location | |||||||||
| Address1: | CHILDRENS HOSPITAL MI HEMATOLOGY/ONCOLOGY | ||||||||
| Address2: | 3901 BEAUBIEN 2ND FLOOR - CARL'S BUILDING | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137455515 | ||||||||
| FaxNumber: | 3137455237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 03/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301074230 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0207X | 4301074230 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Hematology-Oncology |
No ID Information.