Provider Demographics
NPI:1174705081
Name:CHIU, VERNON SY (MD)
Entity type:Individual
Prefix:
First Name:VERNON
Middle Name:SY
Last Name:CHIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608-A AIRPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504
Mailing Address - Country:US
Mailing Address - Phone:252-523-8513
Mailing Address - Fax:252-317-2096
Practice Address - Street 1:608-A AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504
Practice Address - Country:US
Practice Address - Phone:252-523-8513
Practice Address - Fax:252-317-2096
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01325207R00000X
PAMT189661207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910137Medicaid
NC2022693Medicare PIN