Provider Demographics
NPI:1902149016
Name:CHI, MING BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:MING
Middle Name:BRUCE
Last Name:CHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1835 SURREY ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-2598
Mailing Address - Country:US
Mailing Address - Phone:816-462-8742
Mailing Address - Fax:
Practice Address - Street 1:3505 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2914
Practice Address - Country:US
Practice Address - Phone:816-387-2500
Practice Address - Fax:816-387-2329
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI192602084P0800X
MO20170106272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry