Healthcare Provider Details

I. General information

NPI: 1699756163
Provider Name (Legal Business Name): CHI-YUN HO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 S BLOOMINGTON ST
GREENCASTLE IN
46135-2212
US

IV. Provider business mailing address

1542 S BLOOMINGTON ST
GREENCASTLE IN
46135-2212
US

V. Phone/Fax

Practice location:
  • Phone: 765-655-2686
  • Fax: 765-655-2687
Mailing address:
  • Phone: 765-655-2686
  • Fax: 765-655-2687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01026480
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: