Healthcare Provider Details

I. General information

NPI: 1023968328
Provider Name (Legal Business Name): TYLER CHEW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 VINE ST
CLINTON IN
47842
US

IV. Provider business mailing address

11052 N SHIRLEY ST
WEST TERRE HAUTE IN
47885-9368
US

V. Phone/Fax

Practice location:
  • Phone: 765-592-3381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: