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General NPI Number Information
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NPI Number | 1073045845
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Entity Type | Individual
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Provider Name | HYUNSOO CHUNG M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 2429 HARRISON AVE
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City | CINCINNATI
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State | OH
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Zip | 45211-7915
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Country | US
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Telephone | 513-452-7005
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Fax | 513-572-3031
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Provider Business Mailing Address
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Address Line | PO BOX 746071
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City | ATLANTA
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State | GA
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Zip | 30374-6071
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Country | US
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Telephone | 312-733-9730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.152215
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License Number State | OH
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