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NPI Code Detail

MEDICARE: INDUK CHUNG

MEDICARE: INDUK CHUNG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246ZE0600XElectroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number : 1295152023
Entity Type Code : Individual
Provider Name (Legal Business Name) : INDUK CHUNG
Provider Business Mailing Address
First Line : PO BOX 73126
Second Line :
City : HOUSTON
State : TX
Zip : 77273-3126
Country : US
Telephone Number : 281-324-5660
Fax Number :
Provider Business Practice Location Address
First Line : 4830 W KENNEDY BLVD STE 600
Second Line :
City : TAMPA
State : FL
Zip : 33609-2584
Country : US
Telephone Number : 281-324-5660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2014
Last Update Date : 03/20/2014

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Directions to “ INDUK CHUNG ” Practice Location

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