Provider Demographics
NPI:1043487937
Name:CHUA, PATRICK C (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:C
Last Name:CHUA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:411 LAUREL ST STE 2350
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3026
Mailing Address - Country:US
Mailing Address - Phone:515-280-4700
Mailing Address - Fax:515-280-4701
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:SUITE 2350
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3017
Practice Address - Country:US
Practice Address - Phone:515-280-4700
Practice Address - Fax:515-280-4701
Is Sole Proprietor?:No
Enumeration Date:2008-05-11
Last Update Date:2015-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA40008207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP01095595OtherRR MEDICARE
IA1043487937OtherWELLMARK BCBS
IA1043487937Medicaid
IAIB1540007Medicare PIN
IAP01095595OtherRR MEDICARE
IAI17647002Medicare PIN