Individual
DR. JERELL DIEGO CHUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH, D.O.
Contact information
Practice address
3512 WILKINSON BLVD STE 130, CHARLOTTE, NC 28208-5698
(980) 999-2964
(877) 691-5325
Mailing address
3512 WILKINSON BLVD STE 130, CHARLOTTE, NC 28208-5698
(980) 999-2964
(877) 691-5325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1620
SC
207Q00000X
Family Medicine Physician
Primary
2023-03221
NC
Other
Enumeration date
05/21/2009
Last updated
04/24/2026
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