Healthcare Provider Details

I. General information

NPI: 1033192109
Provider Name (Legal Business Name): STEPHEN FRANCIS THUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 GRANT ST DEPT 8TH
BRIDGEPORT CT
06610-2805
US

IV. Provider business mailing address

395 W 12TH AVE 5TH FLOOR
COLUMBUS OH
43210-1267
US

V. Phone/Fax

Practice location:
  • Phone: 203-384-4048
  • Fax:
Mailing address:
  • Phone: 614-293-8513
  • Fax: 614-293-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number043414
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number35.098343
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number043414
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: