Individual
DOMINGO T CHUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1092 HARRISON AVE, ELKINS, WV 26241-3671
(304) 636-6065
Mailing address
PO BOX 2237, ELKINS, WV 26241-2237
(304) 636-6065
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
09561
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130598000
—
WV
Enumeration date
07/13/2005
Last updated
01/13/2010
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