Healthcare Provider Details

I. General information

NPI: 1467531343
Provider Name (Legal Business Name): CHAW P.SUN.,M.D.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9337 CALUMET AVE SUITE B
MUNSTER IN
46321-2894
US

IV. Provider business mailing address

9337 CALUMET AVE SUITE B
MUNSTER IN
46321-2894
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-1213
  • Fax: 219-836-1213
Mailing address:
  • Phone: 219-836-1213
  • Fax: 219-836-1213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01027634A
License Number StateIN

VIII. Authorized Official

Name: CHAW P SUN
Title or Position: PRESIDENT
Credential: MD
Phone: 219-836-1213