Provider Demographics
NPI:1902955768
Name:HWU, CHARLES JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOSEPH
Last Name:HWU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHING YUAN
Other - Middle Name:
Other - Last Name:HWU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:136 30 MAPLE AVENUE
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3867
Mailing Address - Country:US
Mailing Address - Phone:718-461-7666
Mailing Address - Fax:718-461-5503
Practice Address - Street 1:136 30 MAPLE AVENUE
Practice Address - Street 2:SUITE 2F
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3867
Practice Address - Country:US
Practice Address - Phone:718-461-7666
Practice Address - Fax:718-461-5503
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147108207RC0000X
CAA37326207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00842526Medicaid
NY65192Medicare ID - Type Unspecified
A61902Medicare UPIN