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General NPI Number Information
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NPI Number | 1073505681
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Entity Type | Individual
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Provider Name | MAURICE K CHUNG M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 01/25/2016
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Provider Practice Location Address
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Address Line | 310 S CABLE RD
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City | LIMA
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State | OH
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Zip | 45805-3110
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Country | US
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Telephone | 419-228-1000
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Fax | 419-227-3085
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Provider Business Mailing Address
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Address Line | 310 S CABLE RD
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City | LIMA
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State | OH
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Zip | 45805-3110
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Country | US
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Telephone | 419-228-1000
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Fax | 419-227-3085
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 000330743I
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 35058390
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License Number State | OH
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