Individual
JANICE CHUA GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3585 LEXINGTON AVE N, SUITE 350, SHOREVIEW, MN 55126-8064
(651) 484-3942
(651) 787-0519
Mailing address
3585 LEXINGTON AVE N, SUITE 350, SHOREVIEW, MN 55126-8064
(651) 251-5280
(651) 251-5282
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41894
MN
2080A0000X
Pediatric Adolescent Medicine Physician
41894
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071695200
—
MN
01
—
1202358
MEDICA
MN
01
—
1203069
MEDICA
MN
01
—
299L6GO
BLUE CROSS BLUE SHIELD
MN
01
—
CP9091022251
PREFERRED ONE
MN
Enumeration date
09/07/2005
Last updated
12/01/2011
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