MEDICARE: CHI WAH YUNG MD

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
1	207W00000X	Ophthalmology Physician	01033839	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295736544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHI WAH YUNG MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE STE 130
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:	317-962-4792
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 W. MICHIGAN ST.
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5209
Country	:	US
Telephone Number	:	317-944-2020
Fax Number	:	317-274-2727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	12/30/2020

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