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Individual

JANICE CHUA GO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

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
Update your record

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