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Individual

JONATHAN CHU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3137 S MERIDIAN RD, SUITE 120, MERIDIAN, ID 83642-7080
(208) 947-6800
(208) 947-6806
Mailing address
3137 S. MERIDIAN RD, SUITE 120, MERIDIAN, ID 83642-1026
(208) 947-6800
(208) 947-6806

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M5991
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003642000
ID
Enumeration date
06/15/2006
Last updated
06/04/2013
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