Provider Demographics
NPI:1871563775
Name:CHOW, HENRY Y (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:Y
Last Name:CHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0937
Mailing Address - Country:US
Mailing Address - Phone:704-403-1308
Mailing Address - Fax:704-403-1194
Practice Address - Street 1:200 MEDICAL PARK DR
Practice Address - Street 2:SUITE 330
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0937
Practice Address - Country:US
Practice Address - Phone:704-403-1308
Practice Address - Fax:704-403-1194
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600485207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC21966OtherBCBS PROVIDER ID
NC8921966Medicaid
NC2223586BOtherMEDICARE PIN, CURRENT
NC8921966Medicaid
NCF91863Medicare UPIN